Elysa Erin Jackson

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Practice address

17920 Huffmeister Rd Ste 250
Cypress, TX 77429-4284

Phone

(281) 904-5416

NPI assigned

Oct 20, 2020

Last updated

Oct 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tetrad Legacy

  dba HomeWell Care Services TX69

  • In Home Supportive Care Agency
  • Cypress, TX
  • NPI 1063146207
  NPD

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1710586706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15410 PATTINGTON CYPRESS DR",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774334792",
            "telephone_number": "281-904-5416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17920 HUFFMEISTER RD STE 250",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774294284",
            "telephone_number": "281-904-5416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ELYSA",
        "middle_name": "ERIN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ecoleman@homewellcares.com",
            "affiliation": "N",
            "endpointDescription": "e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "17920 Huffmeister Rd Ste 250",
            "city": "Cypress",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774294284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Thomson Ivins, LPC
• Doris Izuwah
• J&J Special Care Inc.
• Kylee Jackovich
• Dystani Brianna Jackson
• Huru Jackson, APRN-BC
• Lynsey M Jackson, BCABA
• Sarah Jackson, DNP
• Brandy Rhae Jacobson, AUD, CCC-A
• Khadija Jaffara

• In Home Supportive Care Agency in Cypress, TX
• Providers in Cypress, TX by specialty
• In Home Supportive Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.