Jackson Reef
NPI 1396398608 · Health Service Clinic/Center · Ormond Beach, FL
Jackson Reef is a Health Service Clinic/Center organization in Ormond Beach, FL (NPI 1396398608).
Provider details
- NPI number
- 1396398608
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- William Self, Owner(386) 487-4673
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Life Is Ketaful
Additional practice locations (1)
- 851 Dunlawton Ave Ste 103Port Orange, FL 32127-4234Phone: (386) 487-4673Fax: (855) 829-5779
Registry dates
- Enumerated
- 2019-07-17
- Last updated
- 2020-08-07
- Certified
- 2020-08-07
Frequently asked questions
- What is Jackson Reef's NPI number?
- Jackson Reef's National Provider Identifier (NPI) is 1396398608, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jackson Reef?
- Jackson Reef is classified in the NPPES registry as Health Service Clinic/Center (Ambulatory Health Care Facilities).
- Where is Jackson Reef located?
- Jackson Reef's practice location on file with NPPES is 495 S Nova Rd Ste 101a, Ormond Beach, FL 32174-8444.
- What is Jackson Reef's phone number?
- The practice phone number listed in the NPPES registry for Jackson Reef is (386) 487-4673.
- Who is the authorized official for Jackson Reef?
- The authorized official listed on Jackson Reef's NPPES record is William Self, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jackson Reef's NPI active?
- Yes — Jackson Reef's NPI (1396398608) is active in the NPPES registry as of the last update on 2020-08-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.