Bianca Jo Jackson

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Practice address

2508 Shannon CT
Hephzibah, GA 30815-6633

Phone

(706) 284-1533

Fax

(706) 284-1533

NPI assigned

Apr 21, 2021

Last updated

Apr 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Bianca Jo Ruff Other name

Electronic endpoints 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649548800000",
    "number": "1992387823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 SHANNON CT",
            "city": "HEPHZIBAH",
            "state": "GA",
            "postal_code": "308156633",
            "telephone_number": "706-284-1533",
            "fax_number": "706-284-1533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 SHANNON CT",
            "city": "HEPHZIBAH",
            "state": "GA",
            "postal_code": "308156633",
            "telephone_number": "706-284-1533",
            "fax_number": "706-284-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BIANCA",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2022-04-10",
        "certification_date": "2022-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "endpointDescription": "Laptop",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "sitters R Us",
            "address_1": "2508 SHannon Ct",
            "city": "Hephzibah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "308156633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "endpointDescription": "lapatop",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2508 SHannon Ct",
            "city": "Hephzibah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "308156633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "endpointDescription": "Laptop",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2508 SHannon Ct",
            "city": "Hephzibah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "308156633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "endpointDescription": "Direct",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2508 SHannon Ct",
            "city": "Hephzibah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "308156633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BIANCA",
            "last_name": "RUFF",
            "middle_name": "JO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nancy Mamie Hunt, SLP
• Nicole Ikara, PHARMD
• John Ingardia
• Rochelle Ingardia
• Kelilah Israel
• Jessica Leeann Jackson
• Latasha Monique Jackson
• Arun K Jain, M.D.
• Kenya Rolanda James, RCD
• JCJ Enterprises

• In Home Supportive Care Agency in Hephzibah, GA
• Providers in Hephzibah, GA by specialty
• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2022; 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.