MEDICARE: JOT ENTERPRISE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	177F00000X	Lodging Provider
2	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1235868878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOT ENTERPRISE LLC

Provider Business Mailing Address
First Line	:	9550 COMMUNITY COMMONS LN APT 152
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-4826
Country	:	US
Telephone Number	:	704-506-0762
Fax Number	:

Provider Business Practice Location Address
First Line	:	9550 COMMUNITY COMMONS LN APT 152
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-4826
Country	:	US
Telephone Number	:	704-506-0762
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JASON ONEAL THOMPSON
Credential	:
Telephone Number	:	704-506-0762

Provider Enumeration Date	:	06/08/2022
Last Update Date	:	08/28/2023

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Directions to “JOT ENTERPRISE LLC ” Practice Location

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