Jackson Reef

Jackson Reef is a healthcare organization registered as Health Service Clinic/Center in Ormond Beach, FL, holding Type 2 (organization) NPI 1396398608 since 2019. The authorized official on file is William Self, Owner.

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NPI	1396398608
Entity type	Organization (Type 2)
Legal business name	Jackson Reef
Other name	<Unavail>
Practice address	495 S NOVA RD STE 101A, Ormond Beach, FL, 32174
Phone	3864874673
Fax	8558295770
Enumeration date	2019-07-17
Last updated in NPPES	2020-08-07

Authorized official

Name	William Self
Title	Owner
Phone	3864874673

Taxonomy & classification

Taxonomy code	Specialty	Primary	License	State
261QH0100X	Health Service Clinic/Center	Primary	—	—

Copy-ready billing details

Provider: Jackson Reef
NPI: 1396398608
Taxonomy: 261QH0100X (Health Service Clinic/Center)
Address: 495 S NOVA RD STE 101A, Ormond Beach, FL, 32174

Providers at this address

NPI	Name	Type	Specialty	Location
1245503093	William Self	Individual	Certified Registered Nurse Anesthetist	Ormond Beach, FL
1437796661	Zentheo LLC	Organization	Psychiatry Physician	Ormond Beach, FL

Verify this record

Cross-check NPI 1396398608 against the authoritative CMS record: view Jackson Reef on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

Where is Jackson Reef located?

The practice location on file with NPPES is in Ormond Beach, FL.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2020-08-07. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2020-08-07.