Summerfield Personal Care Home LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

SUMMERFIELD PERSONAL CARE HOME LLC

Practice address

12166 Highway 212
Covington, GA 30014-7876

Phone

(678) 600-6704

Fax

(404) 745-8410

NPI assigned

Apr 22, 2024

Last updated

Aug 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brenda Snow JacobsNPI 1104326834

Title

Administrator/Provider

Phone

(678) 600-6704

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brenda Snow Jacobs

  • Child Intellectual and/or Developmental Disabilities Respite Care
  • McDonough, GA
  • NPI 1104326834
  Authorized official Same address or phone

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722729600000",
    "number": "1083469092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12166 HIGHWAY 212",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300147876",
            "telephone_number": "678-600-6704",
            "fax_number": "404-745-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12166 HIGHWAY 212",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300147876",
            "telephone_number": "678-600-6704",
            "fax_number": "404-745-8410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERFIELD PERSONAL CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-08-04",
        "certification_date": "2024-08-04",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "SNOW",
        "authorized_official_title_or_position": "ADMINISTRATOR/PROVIDER",
        "authorized_official_telephone_number": "678-600-6704"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Khadijah Stroud-McCottrie, NCAC II, CCS, SAM
• Derek M Studer
• Shelly Studer, LCSW
• Avinash Sukhu, PHARMD
• Karen E Sullivan, MD
• Suncrest Home Health of Georgia, Inc. (Adoration Home Health)
• Sunshine Psychiatric Consultant Care
• Barbara Lee Anne Susin, C.N.M.
• Johnny M Sutton
• Tiffany Chaffin Swales, MS, ATC, LAT

• Adult Care Home Facility in Covington, GA
• Providers in Covington, GA by specialty
• Adult Care Home Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.