Providers Inc LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PROVIDERS INC LLC

Practice address

15022 Sunny Ridge CT Apt 203
Woodbridge, VA 22191-3967

Phone

(202) 439-3667

NPI assigned

Dec 2, 2024

Last updated

Dec 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jatai L JacksonNPI 1962909259

Title

Ceo/Director

Phone

(202) 439-3667

Specialties & licenses 1

Addresses

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.

• Jatai Jackson

  • Community Health Worker
  • Woodbridge, VA
  • NPI 1962909259
  NPD Authorized official

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1689490096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15022 SUNNY RIDGE CT APT 203",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913967",
            "telephone_number": "202-439-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15022 SUNNY RIDGE CT APT 203",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913967",
            "telephone_number": "202-439-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDERS INC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JATAI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO/DIRECTOR",
        "authorized_official_telephone_number": "202-439-3667"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.