Organization Active NPI

Grand Haven Health

  • In Home Supportive Care Agency
  • Jackson, TN
National Provider Identifier
1487531174
Registry record updated Aug 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
GRAND HAVEN HEALTH
Practice address
620 Old Hickory Blvd Ste 440C
Jackson, TN 38305-2904
Phone
(731) 330-4769
NPI assigned
Aug 16, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2025

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

Authorized official

Name
Krystle BurtonNPI 1356125611
Title
Agency Owner
Phone
(731) 330-4769

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Home Health Agency 251E00000X
Community/Behavioral Health Agency 251S00000X
In Home Supportive Care Agency 253Z00000X Primary
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

620 Old Hickory Blvd Ste 440C
Jackson, TN 38305-2904

Mailing address

620 Old Hickory Blvd Ste 440C
Jackson, TN 38305-2904

National Provider Directory

National Provider Directory

Locations

620 Old Hickory Blvd
Ste 440C
Jackson, TN 38305
Phone (731) 330-4769

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": "1755302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755302400000",
    "number": "1487531174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 OLD HICKORY BLVD STE 440C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 OLD HICKORY BLVD STE 440C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052904",
            "telephone_number": "731-330-4769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND HAVEN HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-16",
        "last_updated": "2025-08-16",
        "certification_date": "2025-08-16",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "KRYSTLE",
        "authorized_official_title_or_position": "AGENCY OWNER",
        "authorized_official_telephone_number": "731-330-4769"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2025; 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.