JAACA MANAGEMENT SERVICES LLC


Address: 5505 New Copeland Rd, Tyler, TX 75703-3955
Phone: 9035219861

JAACA MANAGEMENT SERVICES LLC (NPI# 1861828956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1861828956
Entity Type Organization
Organization Name JAACA MANAGEMENT SERVICES LLC
Practice Address 5505 New Copeland Rd
Tyler
TX 75703-3955
Mailing Address Po Box 6008
Tyler
TX 75711-6008
Practice Telephone 9035219861
Enumeration Date 2013-09-20
Last Update Date 2013-09-20
Authorized Official Name DR. SANFORD E WATKINS (OWNER)
Authorized Official Telephone 9035219861
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207R00000X Internal Medicine M3109 TX Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TX INDIVIDUAL NPI 1992781090 01

Office Location

Street Address 5505 NEW COPELAND RD
City TYLER
State TX
Zip Code 75703-3955

Providers in the same location

NPI Name Taxonomy Address Enumeration
1538372966 Kimberly Ann Testa Physical Therapist 5505 New Copeland Rd, Tyler, TX 75703-3955 2007-05-08
1922640879 Rodney Smiley Nurse Practitioner 5505 New Copeland Rd, Tyler, TX 75703-3955 2019-10-11
1629550199 Cathy Marie Wise Physical Therapy Assistant 5505 New Copeland Rd, Tyler, TX 75703-3955 2018-08-31
1174005607 Kathryn Hope Johnson Occupational Therapy Assistant 5505 New Copeland Rd, Tyler, TX 75703-3955 2018-08-31
1720560139 Stephen Greene Occupational Therapist 5505 New Copeland Rd, Tyler, TX 75703-3955 2018-08-31
1972085520 Mary E Henson Physical Therapy Assistant 5505 New Copeland Rd, Tyler, TX 75703-3955 2018-08-30
1871075440 Dayna Graves Occupational Therapy Assistant 5505 New Copeland Rd, Tyler, TX 75703-3955 2018-08-30
1194206987 Susan Dailey Occupational Therapy Assistant 5505 New Copeland Rd, Tyler, TX 75703-3955 2018-08-28
1174004329 Jennifer M Washington Physical Therapy Assistant 5505 New Copeland Rd, Tyler, TX 75703-3955 2018-08-26
1487135125 Chona Labrador Physical Therapist 5505 New Copeland Rd, Tyler, TX 75703-3955 2018-08-21
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174155477 Choice Supportive Care Team Inc. Family Medicine 4293 Kinsey Drive, Tyler, TX 75703 2020-02-05
1770052532 Refinery Chiropractic LLC Chiropractor 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 2018-11-21
1215419353 Deidre Lynn Fergason Occupational Therapy Assistant 3505 Old Jacksonville Hwy, Tyler, TX 75703 2018-09-05
1710473681 Justin Taylor Ross Dentist 8938 S Broadway Ave Ste 380, Tyler, TX 75703 2018-07-03
1457843450 Adam Tyler Barnes, Dds of Texas II, Pllc Dentist 8938 South Broadway, Ste 480, Tyler, TX 75703 2018-06-05
1083106462 Integrity Health Internal Medicine 5605 Old Bullard Rd Ste B, Tyler, TX 75703 2018-06-01
1427572544 Cody Wayne Graham Pharmacist 5415 S. Broadway Ave., Tyler, TX 75703 2017-07-31
1750805941 Roger Bryan Chapman Nurse Practitioner 6115 New Copeland Rd, Tyler, TX 75703 2017-07-28
1427570084 Darah Lynne Dahlem Speech-Language Pathologist 401 E. Front Street Ste 123, Tyler, TX 75703 2017-07-14
1194267468 Herman Lester Hampton Jr. Surgery 5803 Regents Row, Tyler, TX 75703 2016-11-17
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Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1386261329 Metabolic Innovations Inc Internal Medicine 1420 Wsw Loop 323 Ste 3, Tyler, TX 75701-9355 2020-06-25
1083106462 Integrity Health Internal Medicine 5605 Old Bullard Rd Ste B, Tyler, TX 75703 2018-06-01
1235487638 Jaaca Medical Internal Medicine 9334 Chisholm Trl, Tyler, TX 75703-0407 2012-08-16
1306040092 Byron Seth Decamp Internal Medicine 619 S Fleishel Ave Ste 203, Tyler, TX 75701-2067 2007-06-14
1225128259 Peter Pitonak Internal Medicine 703 E Fleishel Ave, Ste 4000, Tyler, TX 75701-2015 2006-10-13
1699867366 Sharlet Slough Do Internal Medicine 6115 New Copeland Rd Ste 240, Tyler, TX 75703 2006-09-29
1346349297 Cynthia J Shepherd Internal Medicine 5414 S Broadway, Tyler, TX 75703-1335 2006-09-21
1245339183 Kevin Glen May Internal Medicine 6723 Highlands Ct, Tyler, TX 75703-0584 2006-09-21
1144329087 David W Ball Internal Medicine 5407 New Copeland Rd Ste 200, Tyler, TX 75703 2006-09-21
1134132749 David James Sloan Internal Medicine 1100 E Lake Street, Suite 240, Tyler, TX 75701 2006-08-14
Find all providers in TYLER

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City TYLER
Zip Code 75703

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Dataset Information

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.

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