JACKSON HEALTH AND WELLNESS CLINIC, LLC (NPI# 1730534090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730534090 |
| Entity Type | Organization |
| Organization Name | JACKSON HEALTH AND WELLNESS CLINIC, LLC |
| Practice Address |
1214b N Race St Glasgow KY 42141-3462 |
| Practice Telephone | 2706296722 |
| Practice Fax Number | 2706296723 |
| Mailing Telephone | 2706296722 |
| Mailing Fax Number | 2706296723 |
| Enumeration Date | 2016-04-24 |
| Last Update Date | 2018-03-27 |
| Authorized Official Name | BRITNEY JACKSON (CEO) |
| Authorized Official Telephone | 2706296722 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100144360 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 511 N Race St, Glasgow, KY 421412913 | 2706796722 | 2706296723 |
| Street Address |
1214B N RACE ST |
| City | GLASGOW |
| State | KY |
| Zip Code | 42141-3462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043521289 | Britney M. Jackson | Nurse Practitioner | 1214b N Race St, Glasgow, KY 42141-3462 | 2010-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710505912 | Adriene Elizabeth Wilson | Nurse Practitioner | 310 N. L. Rogers Blvd., Glasgow, KY 42141 | 2020-07-14 |
| 1649896648 | Katrina Antonette Casanova Tinoco | Student in an Organized Health Care Education/Training Program | 1325 North Race St., University of Louisville/glasgow, Glasgow, KY 42141 | 2020-06-25 |
| 1245744630 | Town and Country Pharmacy Inc. | Durable Medical Equipment & Medical Supplies | 742a East Main Street, Glasgow, KY 42141 | 2017-11-22 |
| 1821413022 | Russell England | Nurse Practitioner | 370 Beaver Mound Circle, Glasgow, KY 42141 | 2014-02-25 |
| 1447507439 | Rehabcare | Skilled Nursing Facility | 109homewoodblvd, Glasgow, KY 42141 | 2012-08-08 |
| 1578847778 | Alexander Kwadwo Somuah | Pharmacist | 1001 W. Main St, Glasgow, KY 42141 | 2011-10-06 |
| 1518240522 | William David Wiley | Pharmacist | 1001 West Main St., Glasgow, KS 42141 | 2011-09-26 |
| 1003121732 | Teresa Katherine Essex | Speech-Language Pathologist | 341 Ginger Rd, Glasgow, KY 42141 | 2010-08-18 |
| 1396915468 | R David Fant Md Psc | Pediatrics | 1407 North Race St, Glasgow, KY 42141 | 2008-03-05 |
| 1003021957 | Eddy Joe Newberry II | Dentist | 400 S. Broadway, Glasgow, KY 42141 | 2007-05-14 |
| Find all providers in zip 42141 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528249752 | David C. German M.d., Psc | Clinic/Center | 211 Professional Park Dr, Glasgow, KY 42141-3486 | 2007-11-15 |
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|---|---|---|---|---|
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| 1679192611 | Temple Triage Pllc | Clinic/Center | 8209 Pennsylvania Run Rd, Louisville, KY 40228-2143 | 2020-04-09 |
| 1154966778 | Member Medical, Inc. | Clinic/Center | 3046 Dolphin Dr Ste 104, Elizabethtown, KY 42701-7182 | 2019-11-07 |
| 1104384213 | Directcare Family Health, Pllc | Clinic/Center | 525 High St Ste 209, Paris, KY 40361-1849 | 2019-03-07 |
| 1407311194 | Quad/med, LLC | Clinic/Center | 739 S Dixie St, Horse Cave, KY 42749 | 2019-02-06 |
| 1265906192 | Core Chiropractic and Family Wellness Pllc | Clinic/Center | 524 E.second St, Lexington, KY 40508 | 2019-01-14 |
| 1134606403 | Hope Primary & Urgent Care Pllc | Clinic/Center | 2157 S Highway 27, Stearns, KY 42647-6297 | 2018-07-19 |
| 1780177618 | Access Med, Pllc | Clinic/Center | 642 E Lexington Ave, Danville, KY 40422-1719 | 2018-06-14 |
| 1447743760 | Remedy House Calls | Clinic/Center | 37 Christopher Dr, South Shore, KY 41175-9447 | 2018-06-12 |
| 1932611019 | Family Care Professional Limited Liability Company | Clinic/Center | 3190 Irvine Rd., Richmond, KY 40475-4047 | 2017-10-30 |
| 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.