JESSICA REYNOLDS MACK (NPI# 1912498205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912498205 |
| Entity Type | Individual |
| Full Name | JESSICA REYNOLDS MACK |
| Practice Address |
6 Adams St Kingston NY 12401-6012 |
| Mailing Address |
59 Grand St Highland NY 12528-1209 |
| Practice Telephone | 8453409170 |
| Mailing Telephone | 8457544944 |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-05-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | NY | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457994097 | Jessica Leigh Mack | Internal Medicine | 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2019-10-27 |
| 1093296113 | Jessica Christina Mack | Nursing Care | 8610 N New Braunfels Ave Ste 405, San Antonio, TX 78217-6358 | 2018-08-27 |
| 1821386426 | Jessica Nicole Mack | Counselor | 1738 S Tremont St, Oceanside, CA 92054-5309 | 2011-07-16 |
| 1144544784 | Jessica Lee Mack | Physical Medicine & Rehabilitation | 1671 Crooked Oak Drive, Lancaster, PA 17601 | 2010-03-25 |
| 1083948459 | Jessica V Mack | Behavioral Analyst | 205 2nd Ave, Apt. 4e, Belmar, NJ 07719-2070 | 2009-10-01 |
| 1710172770 | Jessica Mack | Advanced Practice Midwife | 1025 Morehead Medical Dr, Suite 400, Charlotte, NC 28204-2963 | 2007-09-12 |
| 1598972044 | Jessica Denise Mack | Dietitian, Registered | 705 Dallas Hwy, Villa Rica, GA 30180-1247 | 2007-05-16 |
| 1104859941 | Jessica M Mack | Specialist | 1971 Western Ave, Albany, NY 12203-5066 | 2006-07-07 |
| Street Address |
6 ADAMS ST |
| City | KINGSTON |
| State | NY |
| Zip Code | 12401-6012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386283786 | Alicia Catherine Griffin | Peer Specialist | 6 Adams St, Kingston, NY 12401-6012 | 2020-01-02 |
| 1831680115 | Tonya Stokes | Peer Specialist | 6 Adams St, Kingston, NY 12401-6012 | 2018-05-23 |
| 1801387196 | Jodi Lynn Mathis | Peer Specialist | 6 Adams St, Kingston, NY 12401-6012 | 2018-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215565783 | Health Quest Medical Practice, PC | Surgery | 1240 Ulster Avenue--breast Depart., Kingston, NY 12401 | 2020-03-31 |
| 1306474879 | Health Quest Medical Practice, PC | Surgery | 1240 Ulster Avenue --surg. Onc. Dept, Kingston, NY 12401 | 2020-03-31 |
| 1811523384 | Health Quest Medcial Practice, PC | Podiatrist | The Center for Wound Healing, 670 Stoneleigh Avenue, Carmel, NY 12401 | 2020-03-17 |
| 1013552181 | Health Quest Medical Practice, PC | Emergency Medicine | 1240 Ulster Avenue, Kingston, NY 12401 | 2019-11-13 |
| 1073156808 | Vala Conklin | Hearing Instrument Specialist | Beltone, 10 Westbrook Lane, Kingston, NY 12401 | 2019-10-24 |
| 1306304860 | Laura Juliane Isele | Dietitian, Registered | 521 Boices Lane Taconic Ddso, Kingston, NY 12401 | 2019-03-04 |
| 1104345107 | Shiv Ramlochan | Licensed Practical Nurse | 1 Family Drive, Kingston, NY 12401 | 2017-09-12 |
| 1346776333 | Sara Bockelmann | Licensed Practical Nurse | 616 Kiersted Ave, Kingston, NY 12401 | 2017-05-11 |
| 1093265472 | Janelle Haylett | Pathology | 121 Rondout Drive, Q, Kingston, NY 12401 | 2016-10-10 |
| 1669830873 | Julie Brady | Counselor | 154 Fair Street #2, Kingston, NY 12401 | 2016-02-02 |
| Find all providers in zip 12401 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386283786 | Alicia Catherine Griffin | Peer Specialist | 6 Adams St, Kingston, NY 12401-6012 | 2020-01-02 |
| 1831680115 | Tonya Stokes | Peer Specialist | 6 Adams St, Kingston, NY 12401-6012 | 2018-05-23 |
| 1801387196 | Jodi Lynn Mathis | Peer Specialist | 6 Adams St, Kingston, NY 12401-6012 | 2018-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790385896 | Gary N/a Peluso | Peer Specialist | 62 Allan Dr, East Norwich, NY 11732-1203 | 2020-10-28 |
| 1043810138 | Ryan Hope Mcgovern | Peer Specialist | 950 S Oyster Bay Rd Bay Road, Hicksville, NY 11801-3510 | 2020-10-28 |
| 1669070207 | Sayeeda Zorita Daniels | Peer Specialist | 111 Woodlawn Ave Apt 2, Buffalo, NY 14209-1713 | 2020-10-15 |
| 1801409842 | Alexander Mannino | Peer Specialist | 419 Palisade Ave, Yonkers, NY 10703-2610 | 2020-08-28 |
| 1053924522 | Graham Joshua Anderson | Peer Specialist | 64 Linwood Ave., Buffalo, NY 14209 | 2020-08-25 |
| 1467064832 | Kenneth Robert Lewis | Peer Specialist | 320 N Goodman St Ste 202320, Rochester, NY 14607-1185 | 2020-08-18 |
| 1700404001 | Kathy Annett Gardini | Peer Specialist | 1914 Brookhaven Ave, Far Rockaway, NY 11691-3626 | 2020-07-13 |
| 1669099826 | Moseka Turkessa James | Peer Specialist | 1220 Remsen Ave # 1, Brooklyn, NY 11236-3925 | 2020-07-02 |
| 1174140545 | Mercedes Busby | Peer Specialist | 118 Brauncroft Ln, Amherst, NY 14226-4957 | 2020-07-01 |
| 1457977258 | Carla J Alomar | Peer Specialist | 414 Martin Rd, Lackawanna, NY 14218-2830 | 2020-06-18 |
| 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.