NPIMap

Organization Active NPI

Jackson County

  • In Home Supportive Care Agency
  • Jackson, MI
National Provider Identifier
1508193046
Registry record updated Jan 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
JACKSON COUNTY
Practice address
1715 Lansing Ave
Suite 672
Jackson, MI 49202-2192
Phone
(517) 788-4364
Fax
(517) 780-4739
NPI assigned
Nov 4, 2009
Last updated
Jan 12, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
JACKSON COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2011

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

Authorized official

Name
Marce O Wandell
Title
Director
Phone
(517) 788-4364

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

1715 Lansing Ave
Suite 672
Jackson, MI 49202-2192

Mailing address

1715 Lansing Ave
Suite 672
Jackson, MI 49202-2192
Phone (517) 788-4364

Other names 1

  • Jackson County Department on Aging Other name

National Provider Directory

National Provider Directory
Part of
Jackson County

Locations

1697 Lansing Ave
Jackson, MI 49202
Phone (517) 788-4420

1715 Lansing Ave
Ste 672
Jackson, MI 49202
Phone (517) 768-8652

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1508193046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 LANSING AVE",
            "address_2": "SUITE 672",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022192",
            "telephone_number": "517-788-4364",
            "fax_number": "517-780-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 LANSING AVE",
            "address_2": "SUITE 672",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022192",
            "telephone_number": "517-788-4364",
            "fax_number": "517-780-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACKSON COUNTY",
        "enumeration_date": "2009-11-04",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "WANDELL",
        "authorized_official_first_name": "MARCE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "517-788-4364"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson County Department on Aging",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; 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.