Tiffany'S Homemaker and Companion

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

TIFFANY'S HOMEMAKER AND COMPANION

Practice address

11039 Colonial Tavern LN
Jacksonville, FL 32221-2123

Phone

(904) 450-1430

NPI assigned

Oct 22, 2019

Organization subpart

No

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

Authorized official

Name

Tiffany McKennonNPI 1720509755

Title

Owner

Phone

(904) 450-1430

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Tiffany's Homemaker And Companion Former legal business name

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tiffany McKennon

  • Home Health Aide
  • Jacksonville, FL
  • NPI 1720509755
  NPD Authorized official

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648425600000",
    "number": "1205479342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11039 COLONIAL TAVERN LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322212123",
            "telephone_number": "904-450-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11039 COLONIAL TAVERN LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322212123",
            "telephone_number": "904-450-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFFANY'S HOMEMAKER AND COMPANION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-22",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A",
        "authorized_official_last_name": "MCKENNON",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-450-1430"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021497100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "tiffanyshmcs@yahoo.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11039 Colonial Tavern Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322212123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Tiffany's Homemaker And Companion",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Tiffany's Homemaker And Companion",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• In Home Supportive Care Agency in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• In Home Supportive Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.