MS. JUDY MARIE JACKSON (NPI# 1548671316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1548671316 |
Entity Type | Individual |
Full Name | MS. JUDY MARIE JACKSON |
Practice Address |
5941 Wilerson Rd. Rex GA 30273-1506 |
Mailing Address |
5941 Wilerson Rd. W Rex GA 30273-1506 |
Practice Telephone | 6782841355 |
Practice Fax Number | 6782841355 |
Mailing Telephone | 6782841355 |
Mailing Fax Number | 6782841355 |
Enumeration Date | 2014-05-15 |
Last Update Date | 2014-05-15 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
031-01-129-1 | GA | Nursing & Custodial Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144860255 | Judy Jackson | Private Vehicle | 29 Morris Dr, Cumberland, VA 23040-2625 | 2020-01-07 |
1962624387 | Judy Eva Jackson | Physical Therapist | 38435 5th St. W, Apt J155, Palmdale, CA 93551 | 2007-05-03 |
1528286705 | Judy Carlene Jackson | Registered Nurse | 10 Davis Ct, Glen Burnie, MD 21060-7709 | 2007-04-23 |
1376512145 | Judy M Jackson | Radiology | 1180 N. Indian Canyon Dr, Ste E218, Palm Springs, CA 92262-4800 | 2006-03-15 |
1851931026 | Judy Jackson | Registered Nurse | 206 Gatewood Ave, High Point, NC 27262-4820 | 2020-01-15 |
1255700571 | Judy Jackson | Counselor | 2801 Buford Hwy Ne, Suite T30, Brookhaven, GA 30329-2149 | 2015-09-16 |
1235486473 | Judy Goldson Jackson | Nurse Practitioner | 2020 S Independence Blvd, Suite 5, Virginia Beach, VA 23453-4776 | 2012-08-07 |
1578847505 | Judy Ellen Jackson | Counselor | 1950 N Okmulgee, Okmulgee, OK 74447-6534 | 2011-10-10 |
1629205224 | Judy Jackson | Marriage & Family Therapist | 110 N Santa Cruz Ave, Suite C, Los Gatos, CA 95030-5919 | 2009-06-22 |
Street Address |
5941 WILERSON RD. |
City | REX |
State | GA |
Zip Code | 30273-1506 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043720246 | Never Forgotten Transportation | Non-emergency Medical Transport (VAN) | 6113 Heisler St, Rex, GA 30273 | 2017-10-03 |
1235668682 | Berthina Gaynell Weaver | Licensed Practical Nurse | 5820 Rex Ridge Loop, Rex, GA 30273 | 2017-06-08 |
1114399573 | Donnita Rountree | Counselor | 6297 Ellenwood Drive, Rex, GA 30273 | 2015-10-26 |
1811378433 | Jillian Simpson | Nurse's Aide | 6668 Biscayne Blvd, Rex, GA 30273 | 2015-06-10 |
1528478864 | Denise Elecia Lyn-bradley | Counselor | 156 Hayes Circle, Rex, GA 30273 | 2014-05-07 |
1699943936 | First Opportunity Home Healthcare,llc. | Home Health | 3113 Caliente Ln, Rex, GA 30273-1002 | 2008-02-20 |
1558370288 | Lynne D Scott | Marriage & Family Therapist | 6188 Highway 42, Rex, GA 30273-1028 | 2006-08-05 |
1538451083 | Ralph Bernard Willliams | Counselor | 6188 Highway 42, Rex, GA 30273-1028 | 2011-05-03 |
1780639518 | Jovans Pharmacy Corp | Pharmacy | 6001 Highway 42, Rex, GA 30273-1030 | 2006-05-23 |
1548560964 | Hope & Grace, LLC | Community Based Residential Treatment Facility, Mental Illness | 5860 Ronnie Dr, Rex, GA 30273-1060 | 2010-11-01 |
Find all providers in zip 30273 |
Taxonomy Code | 311ZA0620X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Custodial Care Facility |
Specialization | Adult Care Home |
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679174437 | United Hands Support Services | Custodial Care Facility | 735 Ridge Rd, Canton, GA 30114-4170 | 2020-11-06 |
1679174429 | Golden Peak Senior Living Corp | Custodial Care Facility | 411 Edmond St, Calhoun, GA 30701-5334 | 2020-11-06 |
1023615531 | Lillian Womble | Custodial Care Facility | 3232 Union Church Road, Warthen, GA 31094 | 2020-10-07 |
1750995155 | Jacqueline Dingle | Custodial Care Facility | 604 Sugarbush Cir, Savannah, GA 31406-4434 | 2020-09-02 |
1114549763 | Idella's Angels | Custodial Care Facility | 270 13th Ave Sw, Cairo, GA 39828-3423 | 2020-05-16 |
1356962062 | Brendas Love Personal Care Home LLC | Custodial Care Facility | 8239 Queens Dr, Jonesboro, GA 30238-2946 | 2020-05-04 |
1801421094 | Lj's Personal Care Home, LLC | Custodial Care Facility | 415 E 18th St Sw, Rome, GA 30161-6544 | 2020-03-08 |
1356984041 | Manuel Carl Mckenzie IIi | Custodial Care Facility | 4893 Candlewood Ln, Stone Mountain, GA 30088-1605 | 2019-10-24 |
1457904310 | Renaissance Healthcare LLC | Custodial Care Facility | 419 Airport Rd, Griffin, GA 30224-4834 | 2019-07-19 |
1225697873 | Tahirah Johnston | Custodial Care Facility | 1657 Hallmark Hills Dr, Griffin, GA 30223-8790 | 2019-06-07 |
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.