Organization Active NPI

Jumpstart Hospice & Palliative Care LLC

  • Community Based Hospice Care Agency
  • Lilburn, GA
National Provider Identifier
1417843236
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
JUMPSTART HOSPICE & PALLIATIVE CARE LLC
Practice address
3100 Five Forks Trickum Rd SW Ste 503B
Lilburn, GA 30047-1888
Phone
(678) 333-3331
Fax
(678) 802-6167
NPI assigned
Jun 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Authorized official

Name
Nichole Yahtal
Title
Owner
Phone
(678) 499-1102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

3100 Five Forks Trickum Rd SW Ste 503B
Lilburn, GA 30047-1888

Mailing address

3100 Five Forks Trickum Rd SW Ste 503B
Lilburn, GA 30047-1888
Phone (678) 333-3331

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2314520Jumpstart Hospice and Palliative Care LLC3100 Five Forks Trickum Road, Suite 503 B, Lilburn, GA 30047Certificate of waiverNov 20, 2026

National Provider Directory

National Provider Directory

Locations

3100 Five Forks Trickum Rd SW
Ste 503B
Lilburn, GA 30047
Phone (678) 333-3331

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1750118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1417843236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 FIVE FORKS TRICKUM RD SW STE 503B",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300471888",
            "telephone_number": "678-333-3331",
            "fax_number": "678-802-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 FIVE FORKS TRICKUM RD SW STE 503B",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300471888",
            "telephone_number": "678-333-3331",
            "fax_number": "678-802-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUMPSTART HOSPICE & PALLIATIVE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-12",
        "status": "A",
        "authorized_official_last_name": "YAHTAL",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-499-1102"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.