Tamika Jackson

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

24123 Greenfield Rd # 311207
Southfield, MI 48075-3125

Phone

(313) 457-4114

NPI assigned

Apr 2, 2024

Last updated

Apr 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Professionalized Home Care LLC

  • In Home Supportive Care Agency
  • Southfield, MI
  • NPI 1154175214
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1003668203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24123 GREENFIELD RD STE 311",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753124",
            "telephone_number": "313-457-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24123 GREENFIELD RD # 311207",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753125",
            "telephone_number": "313-457-4114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24123 Greenfield Rd Ste 311",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480753124",
            "country_code": "US",
            "telephone_number": "313-457-4114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TAMIKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-04-02",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laschay Jackson
• Meghan E Jackson, DPT
• Nikkitta Antoinette Jackson
• Qiana Jackson
• Rayshonda Jackson
• Jacob Rayis, PLLC (The Counselor Therapy)
• David Jacobs, MD
• La'Shea Francene Jacobs, RN
• Timperince Jacobs
• John Jacquart, MA

• Personal Care Attendant in Southfield, MI
• Providers in Southfield, MI by specialty
• Personal Care Attendant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.