Jacop Healthcare Services Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

JACOP HEALTHCARE SERVICES INC

Practice address

3560 Quannah Dr.
Grand Prairie, TX 75052-8875

Phone

(972) 352-4194

Fax

(972) 352-4194

NPI assigned

Jun 3, 2010

Organization subpart

No

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

Authorized official

Name

Angela Ananti

Title

Administrator and Supervising Nurse

Phone

(972) 352-4194

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Home health agency certification: CCN 747598

Legal name

JACOP HEALTHCARE SERVICES INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Sep 10, 2011

Last certification

Jul 15, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

May 23, 2010 in TX

Enrollment address

3560 Quannah Drive
Grand Prairie, TX 75052-8875

Listed as

Jacop Healthcare Services IncCCN 747598

Ownership

Proprietary

Certified

Sep 10, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Victorine Tebong, FNP-C

  • Family Nurse Practitioner
  • Cedar Hill, TX
  • NPI 1093344400

  Corporate Director

  CMS ownership

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275523200000",
    "number": "1245550052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 QUANNAH DR.",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528875",
            "telephone_number": "972-352-4194",
            "fax_number": "972-352-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 QUANNAH DR.",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528875",
            "telephone_number": "972-352-4194",
            "fax_number": "972-352-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOP HEALTHCARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-03",
        "last_updated": "2010-06-03",
        "status": "A",
        "authorized_official_last_name": "ANANTI",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "ADMINISTRATOR AND SUPERVISING NURSE",
        "authorized_official_telephone_number": "972-352-4194"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chissy Lynn Jackson, LCSW
• Courtney Danielle Jackson, MPH
• Hanna Mae Jackson, PTA
• Sharon Ruth Jackson
• Taylor Jackson
• Alexis Jaimes, MSN, APRN, PMHNP-BC
• Parto Jalali, MD
• Talatou Jallow
• James Ian Ballou, LLC
• James R. Almand Jr MD Professional Medical Center Association

• Home Health Agency in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.