NPIMap

Organization Active NPI

Tennessee Community Services Agency

  • In Home Supportive Care Agency
  • Jackson, TN
National Provider Identifier
1124356258
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
10000000004532 Issued in TN
Legal business name
TENNESSEE COMMUNITY SERVICES AGENCY
Practice address
6 Stonebridge Blvd
Ste G
Jackson, TN 38305-2166
Phone
(731) 984-9030
Fax
(731) 664-4623
NPI assigned
Dec 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Authorized official

Name
Thomas D McWherter
Title
Executive Director
Phone
(731) 884-2630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 10000000004532 TN Primary

Addresses

Primary practice location

6 Stonebridge Blvd
Ste G
Jackson, TN 38305-2166

Mailing address

PO Box 368
1604 West Reelfoot Avenue
Union City, TN 38281-0368
Phone (731) 884-2640

Other identifiers 1

IdentifierTypeStateIssuer
H445-085MedicaidTN

National Provider Directory

National Provider Directory
Tax ID family
Tennessee Community Services Agency6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6 Stonebridge Blvd
Ste G
Jackson, TN 38305
Phone (731) 984-9030

NPI Registry JSON

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259625600000",
    "number": "1124356258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "address_2": "1604 WEST REELFOOT AVENUE",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382810368",
            "telephone_number": "731-884-2640",
            "fax_number": "731-884-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 STONEBRIDGE BLVD",
            "address_2": "STE G",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052166",
            "telephone_number": "731-984-9030",
            "fax_number": "731-664-4623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE COMMUNITY SERVICES AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-01",
        "last_updated": "2009-12-01",
        "status": "A",
        "authorized_official_last_name": "MCWHERTER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "731-884-2630"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "TN",
            "license": "10000000004532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H445-085",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.