Individual provider Active NPI

Jessica Clinkscales

  • Home Health Aide
  • Sumter, SC
National Provider Identifier
1902640659
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
IHCP-2176 Issued in SC
Practice address
830 S Pike W
Sumter, SC 29150-2665
Phone
(803) 565-9813
NPI assigned
Jun 19, 2024
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X IHCP-2176 SC Primary

Addresses

Primary practice location

830 S Pike W
Sumter, SC 29150-2665

Mailing address

418 Grand National LN
Elgin, SC 29045-7113
Phone (803) 565-9813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IHCP-2176SCMDHome Health Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Your Companion Home Care CurrentSince Aug 18, 2024 Accepting new patients

Locations

830 S Pike W
Sumter, SC 29150
Phone (803) 565-9813

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1902640659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 GRAND NATIONAL LN",
            "city": "ELGIN",
            "state": "SC",
            "postal_code": "290457113",
            "telephone_number": "803-565-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S PIKE W",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502665",
            "telephone_number": "803-565-9813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINKSCALES",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "SC",
            "license": "IHCP-2176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.