Kellie Nichelle Jackson

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

13923 Painted Bunting LN
Riverview, FL 33579-3525

Phone

(813) 304-8251

NPI assigned

Apr 11, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Infinite Heart Support Care Services, LLC

  • In Home Supportive Care Agency
  • Temple Terrace, FL
  • NPI 1194580613
  NPD Authorized official

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

{
    "created_epoch": "1775865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775865600000",
    "number": "1184567414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13923 PAINTED BUNTING LN",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335793525",
            "telephone_number": "813-304-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13923 PAINTED BUNTING LN",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335793525",
            "telephone_number": "813-304-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KELLIE",
        "middle_name": "NICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-11",
        "last_updated": "2026-04-11",
        "certification_date": "2026-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yanet Izaguirre Candina
• Stephanie Anabella Izquierdo
• J & S Group Homes
• J17 Premier Transport
• Jennifer Rennee Jacks
• Madison Jackson, CCC-SLP
• Idamir Calderon Jacobs, CRNA
• Jacqueline Warner Garman, LCSW, PA
• Christa Jallorina, LCSW-C
• Ajahlique James

• Personal Care Attendant in Riverview, FL
• Providers in Riverview, FL by specialty
• Personal Care Attendant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2026; 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.