Individual provider Active NPI

Marketta Haynes

  • In Home Supportive Care Agency
  • Jackson, TN
National Provider Identifier
1730970070
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Practice address
128 Bedford White Rd
Jackson, TN 38305-5930
Phone
(731) 217-7884
NPI assigned
May 15, 2025
Last updated
Feb 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NU
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU
Nurse's Aide 376K00000X 00221558 TN
In Home Supportive Care Agency 253Z00000X NU Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

128 Bedford White Rd
Jackson, TN 38305-5930

Mailing address

128 Bedford White Rd
Jackson, TN 38305-5930
Phone (731) 217-7884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00221558TNMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1730970070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 BEDFORD WHITE RD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383055930",
            "telephone_number": "731-217-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 BEDFORD WHITE RD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383055930",
            "telephone_number": "731-217-7884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "MARKETTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-15",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "TN",
            "license": "00221558",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.