Iconic Homecare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ICONIC HOMECARE LLC

Practice address

270 Hosey Mikell Rd
Bassfield, MS 39421

Phone

(888) 506-5336

Fax

(662) 593-0502

NPI assigned

Nov 29, 2023

Last updated

Nov 29, 2023By 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

Mrs. Amanda EasterlingNPI 1083349062

Title

Manager

Phone

(888) 506-5336

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Courtney Easterling, LPN

  • Licensed Practical Nurse
  • Bassfield, MS
  • NPI 1083349062
  NPD Authorized official

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

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1760258909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 728",
            "city": "BASSFIELD",
            "state": "MS",
            "postal_code": "394210728",
            "telephone_number": "888-506-5336",
            "fax_number": "662-593-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 HOSEY MIKELL RD",
            "city": "BASSFIELD",
            "state": "MS",
            "postal_code": "39421",
            "telephone_number": "888-506-5336",
            "fax_number": "662-593-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICONIC HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "EASTERLING",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "888-506-5336",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe Elayne Crittenden, COTA
• Amanda Courtney Easterling, LPN
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• Randy S Hathorn, DMD
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• New Point Pharmacy Inc. (Newpointe Pharmacy #2)
• Howard Curtis Nobles Jr., CNP

• Home Health Agency in Bassfield, MS
• Providers in Bassfield, MS by specialty
• Home Health Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.