MICAH'S HOME CARE (NPI# 1104121862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104121862 |
| Entity Type | Organization |
| Organization Name | MICAH'S HOME CARE |
| Practice Address |
2444 Commerce Rd Ste 232 Jacksonville NC 28546-7560 |
| Mailing Address |
310 Georgetown Rd Jacksonville NC 28540-4112 |
| Practice Telephone | 7046056406 |
| Mailing Telephone | 7046056406 |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2011-01-18 |
| Authorized Official Name | PAULETTE WASHINGTON (OWNER) |
| Authorized Official Telephone | 7046056406 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
HC4279 | NC | Nursing Service Related Providers |
| Street Address |
2444 COMMERCE RD STE 232 |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-7560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972141224 | Ami B Kowalski | Technician | 8161 Crosswind Rd, Jacksonville, FL 32244-5453 | 2019-12-17 |
| 1104462423 | Geoffrey C Lane | Technician | 4216 Old Mill Cove Trl W, Jacksonville, FL 32277-1582 | 2019-11-21 |
| 1831759141 | Stephanie R Forde | Technician | 12379 Glimmer Way, Jacksonville, FL 32219-1867 | 2019-06-18 |
| 1093279572 | Andrew Jay Jackson | Technician | 125 County Road 4209, Jacksonville, TX 75766-5574 | 2019-01-29 |
| 1790259729 | Juanita R. Cooks | Technician | 3224 Liberty Cir, Jacksonville, FL 32206-2101 | 2019-01-12 |
| 1669945606 | Suzie Pennington | Technician | 7541 Fawn Lake Dr N, Jacksonville, FL 32256-3665 | 2019-01-02 |
| 1518439876 | Angela Rand | Technician | 1710 Naldo Ave, Jacksonville, FL 32207-3138 | 2018-12-27 |
| 1366913394 | Sandra Prince Alvey | Technician | 2829 Seville Ct, Jacksonville, FL 32207-4622 | 2018-12-17 |
| 1235600321 | Angela Justina Mcdonald | Technician | 3047 Mikris Dr E, Jacksonville, FL 32225-7607 | 2018-12-16 |
| 1306317359 | Lauren Renee Simao | Technician | 1665 Cedar Bay Rd, Jacksonville, FL 32218-4971 | 2018-12-16 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
Please comment or provide details below to improve the information on MICAH'S HOME CARE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.