NPIMap

Organization Active NPI

Tj3Am3

  • Home Health Agency
  • Vicksburg, MS
National Provider Identifier
1912179078
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
R870313 Issued in MS
Legal business name
TJ3AM3
Practice address
104 Greenview Dr
Vicksburg, MS 39183-9003
Phone
(601) 638-6262
NPI assigned
Mar 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Authorized official

Name
Ms. Michelle L Hawkins, RN
Title
R.N. Sole Proprietor
Phone
(601) 638-6262

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X R870313 MS Primary
Community Based Hospice Care Agency 251G00000X R870313 MS

Addresses

Primary practice location

104 Greenview Dr
Vicksburg, MS 39183-9003

Mailing address

104 Greenview Dr
Vicksburg, MS 39183-9003
Phone (601) 638-6262

National Provider Directory

National Provider Directory
Tax ID family
On Call Nursing Agency2 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": "1206662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1912179078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 GREENVIEW DR",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391839003",
            "telephone_number": "601-638-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 GREENVIEW DR",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391839003",
            "telephone_number": "601-638-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TJ3AM3",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-28",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "R.N. SOLE PROPRIETOR",
        "authorized_official_telephone_number": "601-638-6262",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MS",
            "license": "R870313",
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": "R870313",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.