Individual provider Active NPI

Melissa Jo Whitehouses-Holcomb

  • In Home Supportive Care Agency
  • Davenport, IA
National Provider Identifier
1033946769
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Practice address
1946 W 3Rd St
Davenport, IA 52802-1607
Phone
(563) 293-0505
NPI assigned
Sep 17, 2024
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU
Public Health or Welfare Agency 251K00000X NU
Community Health Clinic/Center 261QC1500X NU
Private Vehicle 347C00000X 510LL3327 IA
Chore Provider 372500000X NU
Adult Companion 372600000X NU
Homemaker 376J00000X NU
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

1946 W 3Rd St
Davenport, IA 52802-1607

Mailing address

1946 W 3Rd St
Davenport, IA 52802-1607
Phone (563) 293-0505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
510LL3327IAMDPrivate Vehicle

Practice roles

OrganizationSpecialtyStatusNew patients
Kizmit LLC Home Health CurrentSince Sep 23, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1033946769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1946 W 3RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528021607",
            "telephone_number": "563-293-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1946 W 3RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528021607",
            "telephone_number": "563-293-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHOUSES-HOLCOMB",
        "first_name": "MELISSA",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "IA",
            "license": "510LL3327",
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.