County of Jackson Office Clerk Board County Commissioners

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

COUNTY OF JACKSON OFFICE CLERK BOARD COUNTY COMMISSIONERS

Practice address

2864 Madison Street
Marianna, FL 32448-4610

Phone

(850) 718-0000

Fax

(850) 718-0048

NPI assigned

Jun 22, 2006

Organization subpart

Yes

Parent organization

JACKSON COUNTY BOARD OF COUNTY COMMISSIONERSAs reported in NPPES

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

Authorized official

Name

Linda Gray

Title

Office Manager

Phone

(850) 718-0000

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Jackson Co Fire Rescue Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Part of

Jackson Co Fire Rescue

Locations

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354492800000",
    "number": "1982640397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2864 MADISON STREET",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324484610",
            "telephone_number": "850-718-0000",
            "fax_number": "850-718-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2864 MADISON STREET",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324484610",
            "telephone_number": "850-718-0000",
            "fax_number": "850-718-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF JACKSON OFFICE CLERK BOARD COUNTY COMMISSIONERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACKSON COUNTY BOARD OF COUNTY COMMISSIONERS",
        "enumeration_date": "2006-06-22",
        "last_updated": "2012-12-03",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-718-0000"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA -RR MEDICARE",
            "identifier": "P00200104",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF FLORIDA",
            "identifier": "A0435",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088024800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Co Fire Rescue",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Ambulance in Marianna, FL
• Providers in Marianna, FL by specialty
• Ambulance in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.