Organization Active NPI

Jaeg Bright Medical Services, Inc.

  • Home Health Agency
  • Houston, TX
National Provider Identifier
1497041123
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
JAEG BRIGHT MEDICAL SERVICES, INC.
Practice address
16000 Park Ten PL Ste 304
Houston, TX 77084-7297
Phone
(713) 779-7042
Fax
(713) 779-7093
NPI assigned
Jun 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Authorized official

Name
Dr. Archibong Nyanibo
Title
Director
Phone
(713) 779-7042

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

16000 Park Ten PL Ste 304
Houston, TX 77084-7297

Mailing address

16000 Park Ten PL Ste 304
Houston, TX 77084-7297
Phone (713) 779-7042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030520000006 TX Part A Provider - Home Health Agency 4385554849 2 other NPIs on this enrollment
Practice locations: Houston, TX

Home health agency certification: CCN 679229

Legal name
JAEG BRIGHT MEDICAL SERVICES, INC.
Doing business as
JAEG BRIGHT MEDICAL SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 6, 2003
Last certification
Nov 15, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jan 1, 2007 in TX
Enrollment address
16000 Park Ten PL
Ste 304
Houston, TX 77084-7297

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
Jaeg Bright Medical Services IncCCN 679229
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Mar 6, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
45D1002374Jaeg Bright Medical Services16000 Park Ten PL, Ste 304, Houston, TX 77084Certificate of waiverAug 5, 2026

National Provider Directory

National Provider Directory

Locations

9894 Bissonnet St
Ste 525
Houston, TX 77036
Phone (713) 779-7042

6420 Hillcroft Ave
Ste 503
Houston, TX 77081
Phone (713) 779-7042

16000 Park Ten Pl
Ste 304
Houston, TX 77084
Phone (281) 965-6118

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Archibong Nyanibo Individual 5% Or Greater Direct Ownership Interest Aug 23, 2011 50%
Corporate Director Dec 1, 2016 50%
W-2 Managing Employee Nov 13, 2007
May Ibiok Individual 5% Or Greater Direct Ownership Interest Dec 1, 2016 50%

NPI Registry JSON

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1497041123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16000 PARK TEN PL STE 304",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770847297",
            "telephone_number": "713-779-7042",
            "fax_number": "713-779-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 PARK TEN PL STE 304",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770847297",
            "telephone_number": "713-779-7042",
            "fax_number": "713-779-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAEG BRIGHT MEDICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-21",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "NYANIBO",
        "authorized_official_first_name": "ARCHIBONG",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "713-779-7042",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.