Medjestic Health Care, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MEDJESTIC HEALTH CARE, LLC

Practice address

2007 N Palace Ave
Tyler, TX 75702-2061

Phone

(903) 571-7539

NPI assigned

Sep 7, 2011

Last updated

Sep 7, 2011By 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

Ms. Shalitris Medlock, RN

Title

Administrator-DCS

Phone

(800) 513-1640

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315353600000",
    "number": "1730460544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 N PALACE AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757022061",
            "telephone_number": "903-571-7539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 N PALACE AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757022061",
            "telephone_number": "903-571-7539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDJESTIC HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-07",
        "last_updated": "2011-09-07",
        "status": "A",
        "authorized_official_last_name": "MEDLOCK",
        "authorized_official_first_name": "SHALITRIS",
        "authorized_official_title_or_position": "ADMINISTRATOR-DCS",
        "authorized_official_telephone_number": "18005131640",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nelida Medina-Perez, LCSW
• Alicia Medina
• Cristina Medina
• Maria Claudia Medina, LVN
• Stephanie Medina
• Ashley Medlock
• Eric Thornton Meek, M.D.
• Lauren Meeker, M.S., SLP
• Jameya Meekins
• Lisa Meeks

• Home Health Agency in Tyler, TX
• Providers in Tyler, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.