Three Finger Jack LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

THREE FINGER JACK LLC

Practice address

10432 Balls Ford Rd Ste 300
Manassas, VA 20109-2517

Phone

(703) 936-5545

NPI assigned

Jul 1, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Ryan McBroomNPI 1851181143

Title

Owner Operator

Phone

(540) 424-3991

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Executive Home Care of Manassas Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan McBroom

  • Home Health Aide
  • Manassas, VA
  • NPI 1851181143
  NPD Authorized official

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

{
    "created_epoch": "1751328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1033008461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10432 BALLS FORD RD STE 300",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10432 BALLS FORD RD STE 300",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092517",
            "telephone_number": "703-936-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE FINGER JACK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-01",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "MCBROOM",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "540-424-3991",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE HOME CARE LICENSE",
            "identifier": "HCO-0006094",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Executive Home Care of Manassas",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Executive Home Care of Manassas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelsey Thompson
• Tamar Thompson
• Deborah Thomson, R. N. M. N. N. P.
• Fredlyn Thornhill, AGNP-C, RN
• Jeffrey Robert Thorpe, D.D.S.
• Thrive Within Counseling Services LLC
• Alexander Tiesi, M.D
• Lisa Demarco Tilley, LPC
• Shanice Richelle Tillman
• Tameca Walker Tines, LPC

• In Home Supportive Care Agency in Manassas, VA
• Providers in Manassas, VA by specialty
• In Home Supportive Care Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.