Active NPI
Alpha Healthcare and Nursing SRVC LLC
- Community Based Hospice Care Agency
- Jackson, MS
National Provider Identifier
1194804542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- PENDING
- 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, 2020
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06636878 | Medicaid | MS |
National Provider Directory
National Provider DirectoryLocations
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.