NPIMap

Organization Active NPI

Earthly Stars, LLC

  • In Home Supportive Care Agency
  • Jacksonville, FL
National Provider Identifier
1861976003
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
EARTHLY STARS, LLC
Practice address
9616 Watershed Dr E
Jacksonville, FL 32220-0905
Phone
(904) 472-5355
NPI assigned
Sep 24, 2018
Last updated
Oct 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Authorized official

Name
Tiffany MosleyNPI 1487138798
Title
Owner/Administrator
Phone
(904) 472-5355

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
In Home Supportive Care Agency 253Z00000X Primary
Developmental Disabilities Clinic/Center 261QD1600X
Child Mental Illness Respite Care 385HR2055X
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X

Addresses

Primary practice location

9616 Watershed Dr E
Jacksonville, FL 32220-0905

Mailing address

9616 Watershed Dr E
Jacksonville, FL 32220-0905
Phone (904) 472-5355

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1861976003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9616 WATERSHED DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322200905",
            "telephone_number": "904-472-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9616 WATERSHED DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322200905",
            "telephone_number": "904-472-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARTHLY STARS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-24",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "MOSLEY",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "904-472-5355"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Oct 16, 2019; 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.