Naketa Renee Jackson

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

22-015617-1 Issued in IN

Practice address

5233 Hohman Ave
Hammond, IN 46320-1742

Phone

(219) 267-1779

NPI assigned

Mar 24, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Morality Home Care

  • In Home Supportive Care Agency
  • Hammond, IN
  • NPI 1437814373
  NPD Authorized official

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1376246710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5233 HOHMAN AVE STE 116",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463201700",
            "telephone_number": "219-267-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5233 HOHMAN AVE",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463201742",
            "telephone_number": "219-267-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "NAKETA",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-24",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "IN",
            "license": "22-015617-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacia Humphrey
• Brandy Marie Hutcheson, PTA
• Chlotile C Ilagan, PT
• Independence Plus-in, LLC
• Indiana Fat Loss Camps
• Gitie S Jaffe, MD
• Marshall Edward James Jr., MD
• Taeisha Jamison
• Jay D Karol DDS
• Jasmine Jenkins, OTR

• In Home Supportive Care Agency in Hammond, IN
• Providers in Hammond, IN by specialty
• In Home Supportive Care Agency in Indiana

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