Individual provider Active NPI

Kelly Jones

  • In Home Supportive Care Agency
  • Collierville, TN
National Provider Identifier
1033974696
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
1000000034386 Issued in TN
Practice address
155 N Main St Ste 101C
Collierville, TN 38017-2650
Phone
(901) 468-9569
Fax
(901) 861-5516
NPI assigned
Feb 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 1000000034386 TN Primary

Addresses

Primary practice location

155 N Main St Ste 101C
Collierville, TN 38017-2650

Mailing address

155 N Main St Ste 101C
Collierville, TN 38017-2650
Phone (901) 468-9569

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
1000000034386TNMDIn Home Supportive Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1033974696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N MAIN ST STE 101C",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172650",
            "telephone_number": "901-468-9569",
            "fax_number": "901-861-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N MAIN ST STE 101C",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172650",
            "telephone_number": "901-468-9569",
            "fax_number": "901-861-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "KELLY",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "TN",
            "license": "1000000034386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collierville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.