Jennicare Home Health Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

05120501 Issued in PA

Legal business name

JENNICARE HOME HEALTH SERVICES LLC

Practice address

4811 Jonestown Rd
Suite 228
Harrisburg, PA 17109-1745

Phone

(717) 545-4853

Fax

(717) 545-0541

NPI assigned

Nov 8, 2013

Last updated

Nov 8, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justina Nwokeji

Title

President

Phone

(717) 545-4853

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316376494. Details of each certification follow.

• CCN 398218 Home health agency · Active · Details

Home health agency certification: CCN 398218

Legal name

JENNICARE HOME HEALTH SERVICES LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 14, 2014

Last certification

Aug 23, 2019

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Jan 20, 2013 in PA

Enrollment address

4813 Jonestown Rd
Ste 205
Harrisburg, PA 17109-1749
HHA Branch

Listed as

Jennicare Home Health Services LLCCCN 398218 · All quality measures

Ownership

Proprietary

Certified

Mar 14, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy

Tax ID family

Jennicare Home Health Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jennicare Home Health Services LLC

  • Home Health Agency
  • Harrisburg, PA
  • NPI 1508389149
  NPD tax ID

Locations

All disclosed owners & managing parties 2

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

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383868800000",
    "number": "1316376494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4811 JONESTOWN RD",
            "address_2": "SUITE 228",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171091745",
            "telephone_number": "717-545-4853",
            "fax_number": "717-545-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 JONESTOWN RD",
            "address_2": "SUITE 228",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171091745",
            "telephone_number": "717-545-4853",
            "fax_number": "717-545-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNICARE HOME HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-08",
        "status": "A",
        "authorized_official_last_name": "NWOKEJI",
        "authorized_official_first_name": "JUSTINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-545-4853"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "05120501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HHA LICENSE",
            "identifier": "05120501",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael James Jeffrey, LCSW
• Richard Haley Jeffries, DO
• Ronna Jelus-Marenger, PA-C
• Tanya Jenkins
• Thomas L Jenkins, OT
• Jennicare Home Health Services LLC
• Katie Sullivan Jensen, CRNA
• Leah Jensen, PA-C
• Nichole Jensen, M.D.
• Alexandar S Jerev, MD

• Home Health Agency in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Home Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; 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.