Jackson Home Care Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

0000000178 Issued in TN

Legal business name

JACKSON HOME CARE SERVICES LLC

Doing business as

Tennova Home Care - Jackson

Practice address

37 Sandstone Cir
Ste 201
Jackson, TN 38305-2073

Phone

(731) 736-3700

Fax

(731) 736-3704

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Patrick Todd Lyles

Title

Sr Vice President

Phone

(502) 891-1044

Specialties & licenses 1

Addresses

Other names 1

• Tennova Home Care - Jackson Doing business as

Listed as

Tennova Home Health - JacksonCCN 447568

Ownership

Proprietary

Certified

Mar 7, 2005

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Locations

Practitioners 2

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

• Amber Henry

  • Occupational Therapy Assistant
  • Dyersburg, TN
  • NPI 1568018778
  NPD (past)
• Michael Prater, SLP

  • Speech-Language Pathologist
  • Dyersburg, TN
  • NPI 1942504931
  NPD (past)

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483920000000",
    "number": "1477598134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9510 ORMSBY STATION RD",
            "address_2": "STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234081",
            "telephone_number": "502-891-1187",
            "fax_number": "502-891-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 SANDSTONE CIR",
            "address_2": "STE 201",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052073",
            "telephone_number": "731-736-3700",
            "fax_number": "731-736-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON HOME CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2017-01-09",
        "status": "A",
        "authorized_official_last_name": "LYLES",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "SR VICE PRESIDENT",
        "authorized_official_telephone_number": "502-891-1044"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TN",
            "license": "0000000178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tennova Home Care - Jackson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Jackson Endocrine and Diabetes Center PC
• Jackson Interventional Pain Center LLC
• Jackson Madison County General Hospital
• Jackson Madison County General Hospital
• Jackson Madison County General Hospital
• Jackson Madison County General Hospital

• Home Health Agency in Jackson, TN
• Providers in Jackson, TN by specialty
• Home Health Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; 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.