JACTOM INC (NPI# 1205088143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205088143 |
| Entity Type | Organization |
| Organization Name | JACTOM INC |
| Other Organization Name | BETHESDA HEALTHCARE |
| Practice Address |
3532 Dunn Rd Eastover NC 28312-8894 |
| Practice Telephone | 9103233223 |
| Practice Fax Number | 9103230177 |
| Mailing Telephone | 9103233223 |
| Mailing Fax Number | 9103230177 |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2008-10-22 |
| Authorized Official Name | MRS. CAROLINE HORNE (ADMINISTRATOR) |
| Authorized Official Telephone | 9103233223 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 922968 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3406188 | 05 | |
| NC | 3405212 | 05 | |
| NC | BCBS | 00956 | 01 |
| Other Name | Type Code |
|---|---|
| Bethesda Healthcare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992724157 | Jactom Inc | Skilled Nursing Facility | 3532 Dunn Road, Fayetteville, NC 28312 | 2006-07-19 |
| Street Address |
3532 DUNN RD |
| City | EASTOVER |
| State | NC |
| Zip Code | 28312-8894 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417500091 | Emmy Lou Autry | Speech-Language Pathologist | 3532 Dunn Rd, Eastover, NC 28312-8894 | 2019-07-22 |
| 1649585498 | Jacqueline Snow Bradley | Occupational Therapy Assistant | 3532 Dunn Rd, Eastover, NC 28312-8894 | 2010-08-17 |
| 1558593541 | Larry A Poper II | Physical Therapy Assistant | 3532 Dunn Rd, Eastover, NC 28312-8894 | 2009-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376185207 | Christine U Jones | Technician | 3801 Stedman Cedar Creek Rd, Fayetteville, NC 28312 | 2019-10-11 |
| 1497305890 | Stephanie Deshawn Cain | Technician | 1250 Colts Pride Dr, Fayetteville, NC 28312 | 2019-09-17 |
| 1477057545 | Accurate Sleep Diagnostic Center LLC | Clinic/Center | 4220 Locks Creek Church Road, Fayetteville, NC 28312 | 2018-03-22 |
| 1245739457 | Heather S Callihan | Home Health | 415 Old Vander Rd, Fayetteville, NC 28312 | 2018-02-03 |
| 1497088371 | Rainbow Pediatrics of Eastover | Pediatrics | 3361 Dunn Rd, Eastover, NC 28312 | 2009-09-10 |
| 1093947798 | Nuvision Home Care, Inc. | Home Health | 1549 River Road, Fayetteville, NC 28312 | 2009-08-13 |
| 1992724157 | Jactom Inc | Skilled Nursing Facility | 3532 Dunn Road, Fayetteville, NC 28312 | 2006-07-19 |
| 1134580442 | Elizabeth Boyle Kleinfelder | Nurse Practitioner | 3551 Dunn Rd, Eastover, NC 28312 | 2016-03-14 |
| 1629458369 | Mato Brown | Social Worker | 511 Middle Rd, Fayetteville, NC 28312 | 2015-06-08 |
| 1225109911 | William I Cross | Emergency Medicine | 2086 Tailwinds Rd, Fayetteville, NC 28312-5001 | 2006-11-13 |
| Find all providers in zip 28312 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841617974 | Christopher Rushmeyer | Nursing Facility/Intermediate Care Facility | 1820 Harris Houston Rd, Unit 621411, Charlotte, NC 28262-9253 | 2014-03-26 |
| 1306284674 | Legacy | Nursing Facility/Intermediate Care Facility | 903 W Main Street, Yadkinville, NC 27055 | 2013-06-10 |
| 1194077024 | Skill Creations | Nursing Facility/Intermediate Care Facility | 2101 Royall Ave, Goldsboro, NC 27534-7408 | 2012-10-02 |
| 1093066375 | Sci-east | Nursing Facility/Intermediate Care Facility | 338 Cooper St, Winterville, NC 28590-9507 | 2012-09-26 |
| 1053662437 | Skill Creations of Clinton | Nursing Facility/Intermediate Care Facility | 223 Forest Trail, Clinton, NC 28328-3353 | 2012-09-26 |
| 1821349101 | Sci-duplin House | Nursing Facility/Intermediate Care Facility | 120 Orville Street, Warsaw, NC 28398-2221 | 2012-09-26 |
| 1801147186 | Skill Creations of Kenansville | Nursing Facility/Intermediate Care Facility | 218 S Stokes Street, Kenansville, NC 28349-0001 | 2012-09-26 |
| 1750632030 | Sci-coastal House I and II | Nursing Facility/Intermediate Care Facility | 1974 W Lakeshore Drive, Wilmington, NC 28401-6856 | 2012-09-26 |
| 1760732994 | Sci-triangle House II | Nursing Facility/Intermediate Care Facility | 1523 Tyonek Dr, Durham, NC 27703-5639 | 2012-09-14 |
| 1275883498 | Skill Creations of Kinston | Nursing Facility/Intermediate Care Facility | 901 Doctors Dr, Kinston, NC 28501-1574 | 2012-09-14 |
| 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.