Tailor Made Outreach Company LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

TAILOR MADE OUTREACH COMPANY LLC

Practice address

301 Higgins Ave Ste 108
Knoxville, TN 37920-3006

Phone

(704) 649-4374

Fax

(865) 999-4961

NPI assigned

May 5, 2017

Organization subpart

Yes

Parent organization

TAILOR MADE OUTREACH COMPANY LLCAs reported in NPPES

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

Authorized official

Name

Shanairea M Camp

Title

Ceo

Phone

(704) 649-4374

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Miracle Healthcare Providers Doing business as

Tax ID family

Tailor Made Outreach Company LLC2 organizations share this tax ID, including this one

Part of

Tailor Made Outreach Company LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Tailor Made Outreach

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1922551282
  NPD tax ID

Locations

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1750817003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4107 HIXSON PIKE",
            "address_2": "SUITE 101",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374153130",
            "telephone_number": "704-649-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HIGGINS AVE STE 108",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379203006",
            "telephone_number": "704-649-4374",
            "fax_number": "865-999-4961"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2627 Providence Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282112238",
            "country_code": "US",
            "telephone_number": "704-649-4374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TAILOR MADE OUTREACH COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TAILOR MADE OUTREACH COMPANY LLC",
        "enumeration_date": "2017-05-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CAMP",
        "authorized_official_first_name": "SHANAIREA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-649-4374"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "TN",
            "license": "1000000020165",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q031164",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miracle Healthcare Providers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah Sue Tackett
• Michelle D Taft
• Mohamed Magdy Mohamed Tageldin, MD
• Omar Tageldin, MD
• Tahc - Tennessee LLC
• Takecare Services
• Jonna Dianne Tallant, BS
• Virginia Tallent
• Talley Chiropractic Services, PLLC
• Christopher Michael Talley, D.C.

• All providers in Knoxville, TN
• In Home Supportive Care Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.