MR. MARCUS S JACKSON SR. (NPI# 1336767128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336767128 |
| Entity Type | Individual |
| Full Name | MR. MARCUS S JACKSON SR. |
| Practice Address |
5615 Shell Rd Pensacola FL 32503-7825 |
| Practice Telephone | 8507916604 |
| Mailing Telephone | 8507916604 |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2020-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811495138 | Marcus Devaughn Jackson | Counselor | 221 Gladys Hodge Rd, Homer, LA 71040-5447 | 2018-02-01 |
| 1770028425 | Marcus Jackson | Counselor | 2313 Almonaster Ave, New Orleans, LA 70117 | 2017-01-04 |
| 1811044845 | Marcus Jackson | Dentist | 8847 Veterans Memorial Blvd Ste B, Metairie, LA 70003-7707 | 2007-01-04 |
| 1548868946 | Marcus Jackson | Pharmacist | 518 Donelson Pike, Nashville, TN 37214-3729 | 2020-10-16 |
| 1063022499 | Marcus K Jackson | Dentist | 521 E Mountain View Ave, Ellensburg, WA 98926-3865 | 2020-07-31 |
| 1992314595 | Marcus Jackson | Case Manager/Care Coordinator | 2880 Central Pkwy, Cincinnati, OH 45225-2302 | 2020-07-29 |
| 1124523899 | Marcus Dior Jackson | In Home Supportive Care | 1913 Tremont St Se, Washington, DC 20020-7604 | 2018-03-26 |
| 1558863076 | Marcus Joseph Jackson | Behavior Technician | 648 Independence Pkwy Ste 300, Chesapeake, VA 23320-5208 | 2018-02-28 |
| 1568821320 | Marcus Jackson | Case Manager/Care Coordinator | 14785 Preston Rd, Suite 550, Dallas, TX 75254-7876 | 2016-02-22 |
| 1720361652 | Marcus Jackson | Psychologist | 320 Princess Ave, North Las Vegas, NV 89030-3809 | 2011-09-27 |
| Street Address |
5615 SHELL RD |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32503-7825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134727472 | Lauren Barrett Evans | Nurse Practitioner | 4700 Bayou Boulevard, Suite 6, Pensacola, FL 32503 | 2020-10-09 |
| 1528666864 | Kelsey Christine Kvartek | Nurse Practitioner | 4700 Bayou Blvd., Suite 6, Pensacola, FL 32503 | 2020-10-09 |
| 1730790551 | Sacred Heart Hospital of Pensacola | Podiatrist | 1890 Summit Blvd, Pensacola, FL 32503 | 2020-08-14 |
| 1891312815 | Sacred Heart Asc, LLC | Clinic/Center | 1890 Summit Boulevard, Suite 210, Pensacola, FL 32503 | 2020-06-26 |
| 1275011744 | Teresa T Jansen | Registered Nurse | 5051 Carpenters Creek Dr, Pensacola, FL 32503 | 2018-08-06 |
| 1639662729 | Florida Physical Therapy Services of Pensacola, LLC | Occupational Therapist | 428 Airport Blvd, Pensacola, FL 32503 | 2018-06-13 |
| 1922595123 | Touch of Love Home Health Care LLC | Home Health | 139 E Burgess Rd Ste B, Pensacola, FL 32503 | 2018-04-13 |
| 1770012106 | Amber Mcclellan | Occupational Therapist | 4551 North Davis Highway, Suite C, Pensacola, FL 32503 | 2017-06-08 |
| 1780123885 | Corinne Georgette-marie Carlson | Registered Nurse | 6809 White Oak Drive, Pensacola, FL 32503 | 2017-02-22 |
| 1538615232 | Kristin E Patton | Dietitian, Registered | 4501 North Davis Hwy, Suite C, Pensacola, FL 32503 | 2016-09-01 |
| Find all providers in zip 32503 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912499336 | Dne Direct Care Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1602 Governors Dr Apt 1623, Pensacola, FL 32514-9435 | 2018-06-01 |
| 1841299450 | Pensacola Developmental Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1 Villa Dr, Pensacola, FL 32506-5535 | 2005-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568294 | Open Skyes Family Care Home, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5600 Sw 36th St, West Park, FL 33023-6106 | 2020-11-08 |
| 1124628565 | Rachelle Homehealth Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8539 Gate Pkwy W Unit 9134, Jacksonville, FL 32216-1037 | 2020-10-26 |
| 1497368203 | Careola LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3248 Landing Vw, Tavares, FL 32778-2035 | 2020-08-31 |
| 1982218764 | The Home W/ Guiding Hands | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1256 N Florida Ave, Tarpon Springs, FL 34689-2004 | 2020-08-31 |
| 1306459359 | Joy-little Enterprise LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9148 Ridge Blvd, Jacksonville, FL 32208-1265 | 2020-08-28 |
| 1720691082 | Ohana In Home Senior Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 421 W Georgia St, Tallahassee, FL 32301-1011 | 2020-08-26 |
| 1003428467 | Pamella Omelda Odoms-brown | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 541 Shirley Dr., Apopka, FL 32712 | 2020-08-18 |
| 1831700020 | Mikerline Lyns | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10941 Winding Creek Ln, Boca Raton, FL 33428-5664 | 2020-08-12 |
| 1902416993 | Faith Care Center, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3800 Inverrary Blvd Ste 408d, Lauderhill, FL 33319-4359 | 2020-08-04 |
| 1063020188 | Kristine Kaiser Cravener | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1095 Beckman Dr, South Daytona, FL 32119-2499 | 2020-07-14 |
| 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.