ELITE HOME CARE OF JAX LLC (NPI# 1104470749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104470749 |
| Entity Type | Organization |
| Organization Name | ELITE HOME CARE OF JAX LLC |
| Practice Address |
16334 Dawnwood Ct Jacksonville FL 32218-0107 |
| Practice Telephone | 9043392611 |
| Mailing Telephone | 9043392611 |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2019-07-31 |
| Authorized Official Name | SHAWNDREA THOMAS-GIBSON (CEO/OWNER) |
| Authorized Official Telephone | 9043392611 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | Agencies | ||
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| N | 251E00000X | Home Health | Agencies | ||
| N | 253Z00000X | In Home Supportive Care | Agencies | ||
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities | ||
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities | ||
| N | 385H00000X | Respite Care | Respite Care Facility | ||
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
16334 DAWNWOOD CT |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32218-0107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684170 | Damon Lamar Baker | Nurse Practitioner | 12533 Sampson Rd, Jacksonville, Fl, FL 32218 | 2020-09-21 |
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1932679594 | Alaina Rachelle Stanley | Counselor | 11683 Spring Board Dr, Jacksonville, FL 32218 | 2018-11-27 |
| 1508345133 | War Cry Ministry Inc | Counselor | 435 Eric Ave, Jacksonville, FL 32218 | 2018-08-14 |
| 1285111484 | St Vincent's Full Service Urgent Care, LLC | Clinic/Center | 15510 Max Leggett Parkway, Ste A, Jacksonville, FL 32218 | 2018-07-20 |
| 1427544501 | Derrick Roberts | Behavioral Analyst | 11302 Forestdale Rd, Jacksonville, FL 32218 | 2018-07-02 |
| 1215420229 | Companion & Compassion LLC | Home Health | 856 Poydras Ln W, Jacksonville, FL 32218 | 2018-06-13 |
| 1952894784 | Michael Alexander Aaro | Dentist | 1840 Dunn Ave Ste 3, Jacksonville, FL 32218 | 2018-06-06 |
| 1235629445 | Melissa C Moree | Counselor | 13453 Main St. North, Suite 104, Jacksonville, FL 32218 | 2018-05-14 |
| 1861900896 | Sheila Nowlin | Physical Therapist | 1034 Dunn Ave, Jacksonville, FL 32218 | 2018-01-11 |
| Find all providers in zip 32218 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386256014 | Jessica Marie Hazelip | Case Manager/Care Coordinator | 2126 N 1st St, Jacksonville, AR 72076-2870 | 2020-08-24 |
| 1235757493 | Terena D Hoover | Case Manager/Care Coordinator | 731 Duval Station Rd Ste 107-257, Jacksonville, FL 32218-0800 | 2020-07-13 |
| 1255955514 | Shan Lowry | Case Manager/Care Coordinator | 1007 Tortoise Way, Jacksonville, FL 32218-7635 | 2020-06-02 |
| 1376175117 | Diane Stover | Case Manager/Care Coordinator | 7001 A. C. Skinner Parkway, Jacksonville, FL 32256 | 2020-02-10 |
| 1780228510 | Equeisha Jones | Case Manager/Care Coordinator | 1006 N Liberty St, Jacksonville, FL 32206-5631 | 2019-11-05 |
| 1447801865 | Sydney Broussard | Case Manager/Care Coordinator | 3544 Saint Johns Bluff Rd S Apt 922, Jacksonville, FL 32224-2674 | 2019-09-26 |
| 1558928291 | Sherri Mason | Case Manager/Care Coordinator | 8005 Renault Dr, Jacksonville, FL 32244-1325 | 2019-05-28 |
| 1760951438 | Tashera Muray Nielsen | Case Manager/Care Coordinator | 7925 Merrill Rd Apt 2809, Jacksonville, FL 32277-6544 | 2018-11-24 |
| 1588147110 | Patricia Ceasar Pitts | Case Manager/Care Coordinator | 13764 Chipperfield Ln, Jacksonville, FL 32226-5832 | 2018-09-10 |
| 1447738307 | Pamela R Wright | Case Manager/Care Coordinator | 10955 Sterling Silver Ct, Jacksonville, FL 32218-7342 | 2018-08-02 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32218 |
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| 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.