Patrice M Jackson-Weathers, CNA

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

CN0014212008 Issued in GA

Practice address

4266 Lindsey Dr
Decatur, GA 30035-1927

Phone

(470) 965-3741

NPI assigned

Jun 8, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

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.

• Diamonds Hands Family Home LLC

  • Home Health Agency
  • Decatur, GA
  • NPI 1659720209
  NPD Authorized official
• M & W Royal Staffing Group

  • Contractor
  • Decatur, GA
  • NPI 1265005573
  NPD Authorized official
• Royal Weathers Logistics Inc

  • Non-emergency Medical Transport (VAN)
  • Decatur, GA
  • NPI 1952165862
  NPD Authorized official

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707523200000",
    "number": "1407236045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 WILLOW RIDGE WAY",
            "city": "AVONDALE ESTATES",
            "state": "GA",
            "postal_code": "300021284",
            "telephone_number": "470-829-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4266 LINDSEY DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300351927",
            "telephone_number": "470-965-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON-WEATHERS",
        "first_name": "PATRICE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2024-02-10",
        "certification_date": "2024-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "WI",
            "license": "344541",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "SC",
            "license": "560249",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "GA",
            "license": "CN0014212008",
            "primary": true
        },
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J D Wallace Enterprises LLC (Family Health Care Services)
• Lynnda Ann Jabaley, R. PH.
• Carla Jack, LCSW
• Jackie Haar LCSW, LLC
• Julie Diane Elizabeth Jackson-Murphy, M.D.
• Althea Brenda Jackson, RN
• Amanda Z. Jackson, O.T.
• Andrea Tiggler Jackson, RPH
• Barbara Ann Jackson, RN
• Courtney Nicole Jackson

• Nurse's Aide in Decatur, GA
• Providers in Decatur, GA by specialty
• Nurse's Aide in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.