Jackie Ross

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

L000000026045 Issued in TN

Practice address

2006 E Center St
Kingsport, TN 37664-2615

Phone

(423) 288-7969

NPI assigned

Oct 7, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1902403447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 E CENTER ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376642615",
            "telephone_number": "423-288-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 E CENTER ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376642615",
            "telephone_number": "423-288-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JACKIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "TN",
            "license": "L000000026045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.carecentraltn.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2006 E Center St",
            "city": "Kingsport",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376642615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marsha G Rose, MSW LCSW
• Stephanie Lynn Rose, PHARMD
• Tina A. Rose, NP
• Angela Jean Rosenbaum, LPN
• Charles Aaron Ross, D.O.
• Kimberly Jo Ross, BS
• Robert A. Rosser, MD
• Eddie Rowe, DPH
• Kristy Rowe
• Timothy Edwin Rowe, PHARM D

• In Home Supportive Care Agency in Kingsport, TN
• Providers in Kingsport, TN by specialty
• In Home Supportive Care Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.