Jackson Center for Independent Living

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

JACKSON CENTER FOR INDEPENDENT LIVING

Practice address

1981 Hollywood Dr
Suite 200
Jackson, TN 38305-4368

Phone

(731) 668-2211

Fax

(731) 668-0406

NPI assigned

Jun 16, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Audrey Beth James

Title

Executive Director

Phone

(731) 668-2211

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1861842296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1981 HOLLYWOOD DR",
            "address_2": "SUITE 200",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054368",
            "telephone_number": "731-668-2211",
            "fax_number": "731-668-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1981 HOLLYWOOD DR",
            "address_2": "SUITE 200",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054368",
            "telephone_number": "731-668-2211",
            "fax_number": "731-668-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON CENTER FOR INDEPENDENT LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "731-668-2211"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q021666",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackson Allergy & Asthma Clinic PLLC
• Jackson Anesthesia & Perioperative Consultants P C
• Jackson Anesthesia and Perioperative Consultants
• Jackson Anesthesiology Group, PLLC
• Jackson Area Council on Alcoholism and Drug Dependency
• Jackson Clinic PA
• Jackson Clinic PA
• Jackson Clinic PA
• Jackson Clinic Pharmacy Inc
• Jackson Clinic Pharmacy Inc

• Voluntary or Charitable Agency in Jackson, TN
• Providers in Jackson, TN by specialty
• Voluntary or Charitable Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.