Jakpa Healthcare Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

008874 Issued in TX

Legal business name

JAKPA HEALTHCARE INC

Practice address

401 Misty LN
Lewisville, TX 75067-6253

Phone

(214) 222-3100

Fax

(214) 222-3103

NPI assigned

Nov 30, 2006

Last updated

Dec 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Ofioritse AgbontaenNPI 1144792391

Title

Administator

Phone

(214) 222-3100

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477620615. Details of each certification follow.

• CCN 453196 Home health agency · Active · Details

Home health agency certification: CCN 453196

Legal name

JAKPA HEALTHCARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 28, 2004

Last certification

Aug 5, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Enrollment address

285 W Southwest Pkwy
Lewisville, TX 75067-7770

Listed as

Jakpa Health Care IncCCN 453196 · All quality measures

Ownership

Proprietary

Certified

Dec 28, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Physical therapy, Speech pathology, Occupational therapy

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

CLIA laboratory certificates

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ofioritse Agbontaen

  • Registered Nurse
  • Lewisville, TX
  • NPI 1144792391
  NPD Authorized official

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1477620615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 W SOUTHWEST PKWY",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750677770",
            "telephone_number": "214-222-3100",
            "fax_number": "214-222-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MISTY LN",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750676253",
            "telephone_number": "214-222-3100",
            "fax_number": "214-222-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAKPA HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "AGBONTAEN",
        "authorized_official_first_name": "OFIORITSE",
        "authorized_official_title_or_position": "ADMINISTATOR",
        "authorized_official_telephone_number": "214-222-3100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "008874",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDCP",
            "identifier": "001013165",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001013167",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001013166",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecka N Jackson, COTA
• Jaime Jacobs
• Melissa Jacobson
• Masoud Jafari
• Anjana S. Jagalur, M.D.
• Jalil a Khan, MD, PA (Pri-Med Care)
• Rahma Shukri Jama-Grupp
• Kayla Jaquez, MOT
• Jason Jorgensen, DO, PLLC
• Saghar Javanshir-Behroozi, PT

• Home Health Agency in Lewisville, TX
• Providers in Lewisville, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.