RUBY JACKSON (NPI# 1104474188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104474188 |
| Entity Type | Individual |
| Full Name | RUBY JACKSON |
| Practice Address |
4046 Damascus Church Rd Westville SC 29175-9542 |
| Practice Telephone | 8034256598 |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2019-09-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487162608 | Ruby J Jackson | Counselor | 302 Azalea Ct, Brandon, MS 39047-7952 | 2018-01-22 |
| 1871974600 | Ruby M Jackson | Community Health Worker | 1230 2nd Ave, Columbus, GA 31901-5241 | 2015-06-17 |
| 1811280217 | Ruby Jackson | Specialist/Technologist | 27700 Euclid Ave, Euclid, OH 44132-3531 | 2011-05-18 |
| 1659462984 | Ruby J Jackson | Counselor | 302 N Jackson St, Starkville, MS 39759-2504 | 2006-09-28 |
| Street Address |
4046 DAMASCUS CHURCH RD |
| City | WESTVILLE |
| State | SC |
| Zip Code | 29175-9542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558968958 | Westville Drug Company LLC | Pharmacy | 301 S. Williams St, Westville, OK 74965-7496 | 2020-10-08 |
| 1861011199 | Maureen Baker | Nurse Practitioner | 29 Edgewater Ave, Westville, NJ 08093-1133 | 2020-04-16 |
| 1194356790 | Kyle Joseph Twist | Case Manager/Care Coordinator | 471076 E 723 Rd, Westville, OK 74965-7005 | 2020-02-01 |
| 1013566546 | Medelite Billing Service Inc | Contractor | 1563 Commander Rd, Westville, FL 32464-3020 | 2019-09-07 |
| 1114573656 | Brenda Noe | Military Health Care Provider | 1796 S Rolling Meadows Dr, Westville, IN 46391-3701 | 2019-08-12 |
| 1639723018 | Jennifer S Garcia | Social Worker | 609 Winding Way, Westville, NJ 08093-2217 | 2019-07-24 |
| 1104478742 | Acenda, Inc. | Community Based Residential Treatment Facility, Mental Illness | 60 Taras Ave, Westville, NJ 08093-2303 | 2019-07-14 |
| 1790348522 | Pain Management of Westville | Anesthesiology | 419 S Williams Avenue, Westville, OK 74965 | 2019-04-17 |
| 1477011146 | Kelsch Associates Inc. New Jersey | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1000 Broadway Apt 312, Westville, NJ 08093-1438 | 2019-03-12 |
| 1821555632 | Kelsch Associates Inc. New Jersey | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1000 Broadway Apt 113, Westville, NJ 08093-1438 | 2019-02-28 |
| Find all providers in WESTVILLE | ||||
| Taxonomy Code | 3747A0650X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Attendant Care Provider |
| An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013521236 | Lasonya Eady | Technician | 6 Wright Pl, Hilton Head, SC 29926-1291 | 2020-09-04 |
| 1891304549 | Emma Lorraine Richardson | Technician | 1497 Woodview Ln, Charleston, SC 29412-8137 | 2020-07-29 |
| 1609494574 | Pamela Mae Byrd | Technician | 1526 Brookstone Dr, Graniteville, SC 29829-3903 | 2020-07-08 |
| 1780206847 | Mary Kiele | Technician | 1131 Woodrow Ln, Loris, SC 29569-6062 | 2020-05-12 |
| 1841810504 | Jaunett James | Technician | 181 Training Rd, Eutawville, SC 29048-9133 | 2020-04-23 |
| 1407485055 | Nancy Bloodsworth | Technician | 5364 Birdie Ln, Hollywood, SC 29449-6292 | 2020-04-06 |
| 1891323580 | Cynthia Phillips | Technician | 1411 Orange Cir, Florence, SC 29506-6315 | 2020-03-30 |
| 1417582099 | Cheryl Ducos | Technician | 230 Lakeview Cir, Woodruff, SC 29388-9336 | 2020-03-04 |
| 1851926422 | Linda Powers | Technician | 2857 Old Charleston Rd, Gilbert, SC 29054-8911 | 2020-03-04 |
| 1053945915 | Daisy Mocks | Technician | 640 Toms Creek Rd, Hopkins, SC 29061-9200 | 2020-02-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.