Individual provider Active NPI

Tamesha Graham

  • In Home Supportive Care Agency
  • Tallahassee, FL
National Provider Identifier
1336610195
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
239393 Issued in FL
Practice address
13626 Capitola Rd
Tallahassee, FL 32317-8021
Phone
(850) 553-1130
NPI assigned
Dec 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X FL
In Home Supportive Care Agency 253Z00000X 239393 FL Primary

Addresses

Primary practice location

13626 Capitola Rd
Tallahassee, FL 32317-8021

Mailing address

1018 Thomasville Rd Ste 110
Tallahassee, FL 32303-6271
Phone (850) 591-0690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
239393FLMDIn Home Supportive Care Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Dependable Diagnostic LLC In Home Supportive Care Current Accepting new patients
Love & Care Senior Companion Service, LLC In Home Supportive Care CurrentSince Sep 8, 2024 Accepting new patients

Locations

1018 Thomasville Rd
Ste 110
Tallahassee, FL 32303
Phone (850) 591-0690

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1336610195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 THOMASVILLE RD STE 110",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323036271",
            "telephone_number": "850-591-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13626 CAPITOLA RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323178021",
            "telephone_number": "850-553-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "TAMESHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "239393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.