Under the Shadows Private Home Care

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

047470140 Issued in GA

Legal business name

UNDER THE SHADOWS PRIVATE HOME CARE

Practice address

208 Curtis Street
Sylvania, GA 30467

Phone

(912) 978-8282

NPI assigned

Feb 22, 2017

Last updated

Feb 22, 2017By 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. Latrell JenkinsNPI 1841684347

Title

Owner

Phone

(912) 978-8282

Specialties & licenses 1

Addresses

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.

• Latrell Jenkins, C.N.A.

  • Home Health Aide
  • Sylvania, GA
  • NPI 1841684347
  NPD (past) Authorized official

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1841739984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 CURTIS ST",
            "city": "SYLVANIA",
            "state": "GA",
            "postal_code": "304672432",
            "telephone_number": "912-564-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 CURTIS STREET",
            "city": "SYLVANIA",
            "state": "GA",
            "postal_code": "30467",
            "telephone_number": "912-978-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNDER THE SHADOWS PRIVATE HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-22",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "LATRELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-978-8282",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "GA",
            "license": "047470140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tattnall Hospital Company, LLC (Optim Medical Center Tattnall Sylvania)
• George Tettegah, MD
• Allyson A Thomas, PHARMD
• Shannon M Thomas, CRNA
• Thrive Therapy and Wellness Services LLC (Thrive Therapy and Wellness Services)
• Walgreen Co (Walgreens #17421)
• Karen Ware
• Weavers Business Services Inc (Weavers Manor)
• Wells Pharmacy Services Inc (Medicap Pharmacy)
• David D Wells, PHARMD

• Exclusive Provider Organization in Sylvania, GA
• Providers in Sylvania, GA by specialty
• Exclusive Provider Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.