Serenity Evolution Care LLC

Primary specialty

Home Health AideTaxonomy code 374U00000X

Legal business name

SERENITY EVOLUTION CARE LLC

Practice address

136 Jennings Rd
Russellville, AR 72802

Phone

(479) 880-3449

NPI assigned

May 23, 2024

Last updated

May 23, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

AFFORDABLE TAXI OF POPE CO LLCAs reported in NPPES

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

Authorized official

Name

Rose ShaddonNPI 1235833302

Title

Owner

Phone

(479) 857-5609

Specialties & licenses 1

Addresses

Other names 2

• Affordable Taxi of Pope Co LLC Former legal business name
• Serenity Evolution Care LLC Former legal business name

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.

• Rose Lee Shaddon, TAXI

  • Driver
  • Russellville, AR
  • NPI 1235833302
  NPD Authorized official

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1508605064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 JENNINGS RD",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72802",
            "telephone_number": "479-880-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 JENNINGS RD",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72802",
            "telephone_number": "479-880-3449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY EVOLUTION CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AFFORDABLE TAXI OF POPE CO LLC",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "SHADDON",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-857-5609"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affordable Taxi of Pope Co LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Serenity Evolution Care LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Nancy Anne Scribner, OTRL
• Angela Scully
• Kassen Sears
• Jeffery Scott Seay, CASE MANAGER PARAPRO
• John Paul Senn, MS, LMFT
• Rose Lee Shaddon, TAXI
• Casi Shadowens
• Nancy T Shaikh
• Laken Shankle
• Kyleigh Mae Shannon

• Home Health Aide in Russellville, AR
• Providers in Russellville, AR by specialty
• Home Health Aide in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.