NPIMap

Organization Active NPI

Harris in Home Supportive Care

  • Homemaker
  • Jacksonville, FL
National Provider Identifier
1760134183
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
Legal business name
HARRIS IN HOME SUPPORTIVE CARE
Practice address
10574 Lake Hollow LN
Jacksonville, FL 32257-3788
Phone
(904) 294-4531
NPI assigned
Jan 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Authorized official

Name
Kayshaun HarrisNPI 1356011696
Title
Owner
Phone
(904) 294-4531

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chore ProviderGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 372500000X
Adult CompanionGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 372600000X
HomemakerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 376J00000X Primary

Addresses

Primary practice location

10574 Lake Hollow LN
Jacksonville, FL 32257-3788

Mailing address

10574 Lake Hollow LN
Jacksonville, FL 32257-3788
Phone (904) 294-4531

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kayshaun@harrisinhomesupportivecare.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1760134183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10574 LAKE HOLLOW LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322573788",
            "telephone_number": "904-294-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10574 LAKE HOLLOW LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322573788",
            "telephone_number": "904-294-4531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRIS IN HOME SUPPORTIVE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "KAYSHAUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-294-4531"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kayshaun@harrisinhomesupportivecare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10574 Lake Hollow Ln",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322573788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.