Mid-South Personal Care Agency, LLC

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

Legal business name

MID-SOUTH PERSONAL CARE AGENCY, LLC

Practice address

83 Harvard Rd
Marion, AR 72364-9738

Phone

(901) 462-1619

NPI assigned

Jun 19, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Jerica Smith

Title

Owner/Ceo

Phone

(901) 462-1619

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1508482001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S BRINKLEY LOOP APT 3",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723645030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 HARVARD RD",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723649738",
            "telephone_number": "901-462-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-SOUTH PERSONAL CARE AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JERICA",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "901-462-1619",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Attendant Care Provider in Marion, AR
• Providers in Marion, AR by specialty
• Attendant Care Provider in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.