LINDA SHORTS HOME (NPI# 1316003668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316003668 |
| Entity Type | Organization |
| Organization Name | LINDA SHORTS HOME |
| Practice Address |
106 Grantham Ln Jacksonville NC 28546-8150 |
| Mailing Address |
180 Coastal Ln Jacksonville NC 28546-6761 |
| Practice Telephone | 9104554480 |
| Mailing Telephone | 9104556724 |
| Mailing Fax Number | 9103465489 |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2015-06-24 |
| Authorized Official Name | MRS. LINDA E GIBSON (DIRECTOR) |
| Authorized Official Telephone | 9104556724 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | MHL067026 | NC | Residential Treatment Facilities |
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
MHL067026 | NC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3408956 | 05 |
| Street Address |
106 GRANTHAM LN |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-8150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295334191 | Aging At Home LLC | Clinic/Center | 1858 Forest Hills Rd, Jacksonville, FL 32208-2535 | 2020-10-21 |
| 1366052623 | New Horizons Supports & Services Inc. | Clinic/Center | 101 Century 21 Dr Ste 203, Jacksonville, FL 32216-9293 | 2020-08-03 |
| 1861041220 | Markedia Louise Daniels | Clinic/Center | 2482 Wylene St, Jacksonville, FL 32209-4576 | 2019-09-09 |
| 1699320838 | True Angels Provider Care Services LLC | Clinic/Center | 5115 Clarendon Rd, Jacksonville, FL 32205-7205 | 2019-08-05 |
| 1538728001 | Tammy Toombs | Clinic/Center | 6722 Arlington Expy, Jacksonville, FL 32211-7234 | 2019-06-10 |
| 1063970358 | Katrina M Johnson | Clinic/Center | 10225 Magnolia Ridge Dr, Jacksonville, FL 32210-4991 | 2019-03-06 |
| 1306303235 | A Bit Above Support Services | Clinic/Center | 6120 Golden Grove Rd W, Jacksonville, FL 32244-2633 | 2019-02-27 |
| 1851880793 | Keiarra Hendrick | Clinic/Center | 250 Cherry Ridge Dr Apt 1021, Jacksonville, FL 32222 | 2018-05-07 |
| 1336638782 | Sharlana Wilson | Clinic/Center | 7854 Smyrna St, Jacksonville, FL 32208-3160 | 2018-05-01 |
| 1770088346 | Marquita Lashell Tinney | Clinic/Center | 9086 Gloucestershire Ct, Jacksonville, FL 32219-4398 | 2018-03-27 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
Please comment or provide details below to improve the information on LINDA SHORTS HOME.
| 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.