THE VILLAS OF JACKSON LLC
NPI 1215438585
Assisted Living Facility in Jackson, MO

Q: What is The Villas Of Jackson LLC's NPI number?

The NPI number for The Villas Of Jackson LLC is 1215438585. It was assigned to this organization in the NPPES registry on February 22, 2018.

Q: What is The Villas Of Jackson LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since February 22, 2018CLIA 26D2129297 · Waiver

670 BROADRIDGE, JACKSON, MO 63755(573) 986-8210(573) 755-5155 Get Directions Write a Review

NPPES record last updated: February 22, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About The Villas Of Jackson Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE VILLAS OF JACKSON LLC (NPI 1215438585) is a healthcare organization registered as an assisted living facility in Jackson, Missouri and active in the NPI registry since February 2018. The organization holds a CLIA Waiver certificate valid through April 17, 2027 and lists Carl Martin Knott, Administrator, as its authorized official.

NPPES Registry Identity

NPI1215438585

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameTHE VILLAS OF JACKSON LLC

Location Address670 BROADRIDGEJackson, MO 63755

Mailing Address670 BroadridgeJackson, MO 63755 · (573) 986-8210 · Fax (573) 755-5155

Phone(573) 986-8210

Fax(573) 755-5155

Organization SubpartNo

Authorized OfficialCarl Martin KnottAdministrator · (573) 986-8210

Enumeration DateFebruary 22, 2018

✔ NPI 1215438585 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in MO · 045129

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

670 BROADRIDGE, Jackson, MO 63755

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2129297

The Villas Of Jackson · Jackson, MO

Active · expires Apr 17, 2027

CLIA Number26D2129297

Laboratory TypeAssisted Living Facility

Certificate Effective DateApril 18, 2025

Certificate Expiration DateApril 17, 2027

Laboratory DirectorJanice Unger

Laboratory Phone(573) 986-8240

Laboratory LocationThe Villas Of Jackson670 Broadridge, Jackson, MO 63755

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is The Villas Of Jackson LLC's NPI number?

The NPI number for The Villas Of Jackson LLC is 1215438585. It was assigned to this organization in the NPPES registry on February 22, 2018.

Where is The Villas Of Jackson LLC located?

The Villas Of Jackson LLC is located at 670 Broadridge, Jackson, MO 63755. The listed phone number is (573) 986-8210.

What is The Villas Of Jackson LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does The Villas Of Jackson LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2129297) is associated with this NPI, valid through April 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for The Villas Of Jackson LLC was last updated on February 22, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.