Individual provider Active NPI

Mischka Sumpter

  • In Home Supportive Care Agency
  • Jacksonville, FL
National Provider Identifier
1104551035
Registry record updated Jul 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
L21000383658 Issued in FL
Practice address
1631 E 19TH St
Jacksonville, FL 32206-3350
Phone
(904) 444-7801
NPI assigned
Jul 24, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2022

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 L21000383658 FL Primary

Addresses

Primary practice location

1631 E 19TH St
Jacksonville, FL 32206-3350

Mailing address

1631 E 19TH St
Jacksonville, FL 32206-3350
Phone (904) 444-7801

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
L21000383658FLMDIn Home Supportive Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1658620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658620800000",
    "number": "1104551035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 E 19TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322063350",
            "telephone_number": "904-444-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 E 19TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322063350",
            "telephone_number": "904-444-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMPTER",
        "first_name": "MISCHKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-24",
        "last_updated": "2022-07-24",
        "certification_date": "2022-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "L21000383658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2022; 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.