JACKSON OPCO, LLC (NPI# 1619419272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619419272 |
| Entity Type | Organization |
| Organization Name | JACKSON OPCO, LLC |
| Practice Address |
434 W North St Jackson MI 49202-3313 |
| Mailing Address |
707 Armstrong Rd Lansing MI 48911-3906 |
| Practice Telephone | 5177873250 |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2016-11-14 |
| Authorized Official Name | DOV GREEN (MANAGER) |
| Authorized Official Telephone | 7329666741 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Street Address |
434 W NORTH ST |
| City | JACKSON |
| State | MI |
| Zip Code | 49202-3313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033151709 | Heartland of Jackson Mi LLC | Skilled Nursing Facility | 434 W North St, Jackson, MI 49202-3313 | 2006-06-10 |
| 1801378161 | Joanne Marie Ickes | Physical Therapist | 434 W North St, Jackson, MI 49202-3313 | 2018-09-04 |
| 1841778420 | Erin Powers | Physical Therapist | 434 W North St, Jackson, MI 49202-3313 | 2018-08-05 |
| 1669974192 | Carrie L Parker | Occupational Therapist | 434 W North St, Jackson, MI 49202-3313 | 2018-02-28 |
| 1699060947 | Mark Shahan Manalp | Physical Therapy Assistant | 434 W North St, Jackson, MI 49202-3313 | 2011-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821590316 | Leslie Dominique Barroso | Social Worker | 834 Kennedy St, Jackson, MI 49202 | 2018-03-01 |
| 1073011136 | Nicole Szarek | Social Worker | 1200 N. West Ave, Jackson, MI 49202 | 2018-01-24 |
| 1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
| 1285081612 | Patricia Decker | Psychologist | 950 West Monroe, Suite 500, Jackson, MI 49202 | 2016-05-16 |
| 1619344314 | Erica Ries | Social Worker | 1200 N West Ave Ste 800, Jackson, MI 49202 | 2015-08-28 |
| 1184007189 | Sarah Johnson | Behavioral Analyst | 818 Winifred St, Jackson, MI 49202 | 2015-07-08 |
| 1871971697 | Scott A Watterson Dds, Pllc | Dentist | 1030 Laurence Ave, Suite 3, Jackson, MI 49202 | 2015-05-13 |
| 1043608680 | Brenda Beverly | Counselor | 1190 West, 1190 West Suite 812, Jackson, MI 49202 | 2015-01-06 |
| 1295091593 | Natalie Ann Kember | Social Worker | 1206 Clinton, Jackson, MI 49202 | 2012-04-11 |
| 1912218728 | Tina Marie Pierce | Respite Care | 225 N Wisner St, Jakson, MI 49202 | 2010-06-25 |
| Find all providers in zip 49202 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326348897 | Laurie L. Mcbride | Skilled Nursing Facility | 180 W University Pkwy Ste H, Jackson, TN 38305-1612 | 2010-10-29 |
| 1407179039 | Caring Hands Community Services Inc | Skilled Nursing Facility | 3318 Longwood Drive, Jackson, MS 39212 | 2010-03-10 |
| 1568791804 | North Street Healthcare LLC | Skilled Nursing Facility | 865 North St, Jackson, MS 39202-3020 | 2009-12-16 |
| 1679712665 | West Tennessee Transitional Care Inc | Skilled Nursing Facility | 597 West Forest Ave, Jackson, TN 38301 | 2009-02-13 |
| 1285802652 | Trilogy Healthcare of Jackson, LLC | Skilled Nursing Facility | 703 Robinson Road, Jackson, MI 49203-2538 | 2008-02-19 |
| 1174732333 | Louisiana War Veterans Home | Skilled Nursing Facility | 4739 Highway 10, Jackson, LA 70748 | 2007-05-22 |
| 1760521256 | Omni Visions, Inc | Skilled Nursing Facility | 50 Directors Row, Jackson, TN 38305 | 2007-02-05 |
| 1326197211 | Cottage Grove Nursing Home, Lp | Skilled Nursing Facility | 1116 Forest Ave, Jackson, MS 39206-3216 | 2007-01-09 |
| 1164597688 | Countryside Care Center, Inc. | Skilled Nursing Facility | 2121 Robinson Rd, Jackson, MI 49203-3658 | 2006-11-21 |
| 1073687083 | Chadwick Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 1900 Chadwick Dr, Jackson, MS 39204-3406 | 2006-11-20 |
| Find all providers in JACKSON | ||||
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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.