NPIMap

Organization Active NPI

Optimum Personal Care & Sitters, Inc.

  • In Home Supportive Care Agency
  • Jackson, MS
National Provider Identifier
1770024416
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
OPTIMUM PERSONAL CARE & SITTERS, INC.
Practice address
4500 N State St
Jackson, MS 39206-5307
Phone
(601) 259-4602
NPI assigned
Mar 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Authorized official

Name
Mr. Carnell Kitchens
Title
Executive Director
Phone
(601) 259-4602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

4500 N State St
Jackson, MS 39206-5307

Mailing address

4500 N State St
Jackson, MS 39206-5307

Other identifiers 1

IdentifierTypeStateIssuer
08559576MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Optimum Personal Care Sitters2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1770024416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392065307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392065307",
            "telephone_number": "601-259-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM PERSONAL CARE & SITTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-14",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "KITCHENS",
        "authorized_official_first_name": "CARNELL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-259-4602",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08559576",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.