Active NPI
Jumpstart Hospice & Palliative Care LLC
- Community Based Hospice Care Agency
- Lilburn, GA
National Provider Identifier
1417843236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2314520 | Jumpstart Hospice and Palliative Care LLC | Certificate of waiver | Nov 20, 2026 |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Home Health Aide
- Lilburn, GA
- NPI 1669289377
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.