Organization Active NPI

Alpha Healthcare and Nursing SRVC LLC

  • Community Based Hospice Care Agency
  • Jackson, MS
National Provider Identifier
1194804542
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
PENDING Issued in MS
Legal business name
ALPHA HEALTHCARE AND NURSING SRVC LLC
Practice address
407 Briarwood Dr
Jackson, MS 39206-3040
Phone
(601) 977-1198
Fax
(601) 977-1193
NPI assigned
Nov 6, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Toya L Gaddis-Brown, R.N.
Title
Administrator
Phone
(601) 977-1198

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X PENDING MS Primary

Addresses

Primary practice location

407 Briarwood Dr
Jackson, MS 39206-3040

Mailing address

PO Box 59446
Jackson, MS 39284-9446
Phone (601) 977-1198

Other identifiers 1

IdentifierTypeStateIssuer
06636878MedicaidMS

National Provider Directory

National Provider Directory

Locations

407 Briarwood Dr
Jackson, MS 39206
Phone (601) 957-7670

407 Briarwood Dr
Ste 201
Jackson, MS 39206
Phone (601) 977-1198

407 Briarwood Dr
Ste 206E
Jackson, MS 39206
Phone (601) 977-1198

407 Briarwood Dr
Ste 207C
Jackson, MS 39206
Phone (601) 977-1198

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194804542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 59446",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392849446",
            "telephone_number": "601-977-1198",
            "fax_number": "601-977-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 BRIARWOOD DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392063040",
            "telephone_number": "601-977-1198",
            "fax_number": "601-977-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA HEALTHCARE AND NURSING SRVC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GADDIS-BROWN",
        "authorized_official_first_name": "TOYA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-977-1198",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06636878",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.