Jacksonville Health Care

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

111535 Issued in TX

Legal business name

JACKSONVILLE HEALTH CARE

Practice address

305 Bonita St
Jacksonville, TX 75766-5743

Phone

(903) 586-3616

Fax

(903) 586-1157

NPI assigned

Oct 6, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Theresa Jean Webb, R.N.

Title

Ddirector of Nursing

Phone

(903) 586-3616

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891783619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 BONITA ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757665743",
            "telephone_number": "903-586-3616",
            "fax_number": "903-586-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 BONITA ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757665743",
            "telephone_number": "903-586-3616",
            "fax_number": "903-586-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "DDIRECTOR OF NURSING",
        "authorized_official_telephone_number": "903-586-3616",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "111535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Jacksonville, TX
• Providers in Jacksonville, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.