JACK CITY, LLC
NPI 1376002931
Durable Medical Equipment & Medical Supplies in Watertown, MA
NPI Status: Active since March 13, 2019
Contact Information
30 CENTER ST
WATERTOWN, MA
ZIP 02472
Phone: (617) 393-1709
Fax: (617) 754-6420
- Organization
- Durable Medical Equipment & Medical Supp...
About JACK CITY, LLC
This page provides the complete NPI Profile along with additional information for Jack City, Llc, a provider established in Watertown, Massachusetts operating as a Durable Medical Equipment & Medical Supplies. The healthcare provider is registered in the NPI registry with number 1376002931 assigned on March 2019. The practitioner's primary taxonomy code is 332B00000X. The provider is registered as an organization and their NPI record was last updated April 2026. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Codey Gillum Pa-c (Ceo)
- NPI
- 1376002931
- Provider Name
- JACK CITY, LLC
- Entity Type
- Organization
- Location Address
- 30 CENTER ST WATERTOWN, MA 02472
- Location Phone
- (617) 393-1709
- Location Fax
- (617) 754-6420
- Mailing Address
- 30 CENTER ST WATERTOWN, MA 02472
- Mailing Phone
- (857) 760-7374
- Mailing Fax
- (617) 754-6420
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-13-2019
- Last Update Date
- 04-20-2026
- Code Navigator
Location Map
Secondary Locations
- 2014 Washington St
Newton, MA 02462
(617) 243-6000 - 125 Parker Hill Ave # 4
Boston, MA 02120
(617) 754-6569 - 125 Parker Hill Ave
Boston, MA 02120
(617) 754-5000 - 70 Walnut St
Wellesley, MA 02481
(774) 517-7555 - 125 Parker Hill Ave # 550
Boston, MA 02120
(617) 602-5707
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Durable Medical Equipment & Medical Supplies
- Taxonomy Code
- 332B00000X
- Type
- Suppliers
- Taxonomy Description
- A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1376002931, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 59 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1376002931, enumerated as an "organization" on March 13, 2019.
The provider is located at 30 CENTER ST WATERTOWN, MA 02472 and the phone number is (617) 393-1709.
Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.
