NPIMap

Organization Active NPI

Jackson Healthcare Services, LLC

  • Home Health Agency
  • Jacksonville, FL
National Provider Identifier
1952980567
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
JACKSON HEALTHCARE SERVICES, LLC
Practice address
5604 Ashleigh Park Dr
Jacksonville, FL 32244-7821
Phone
(190) 442-8318
NPI assigned
Apr 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Authorized official

Name
Je-Je W JacksonNPI 1982148508
Title
Owner/Program Manager
Phone
(904) 428-3182

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

5604 Ashleigh Park Dr
Jacksonville, FL 32244-7821

Mailing address

5604 Ashleigh Park Dr
Jacksonville, FL 32244-7821
Phone (190) 442-8318

Other identifiers 1

IdentifierTypeStateIssuer
013844800MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jhs-homehealth@mail.com

National Provider Directory

National Provider Directory
Tax ID family
Jackson Healthcare Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617321600000",
    "number": "1952980567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5604 ASHLEIGH PARK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322447821",
            "telephone_number": "190-442-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 ASHLEIGH PARK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322447821",
            "telephone_number": "190-442-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-04-02",
        "certification_date": "2021-03-14",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JE-JE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/PROGRAM MANAGER",
        "authorized_official_telephone_number": "904-428-3182"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013844800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhs-homehealth@mail.com",
            "affiliation": "N",
            "address_1": "5604 Ashleigh Park Dr",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322447821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; 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.