DIVINE HEALTHCARE (NPI# 1205234002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205234002 |
| Entity Type | Organization |
| Organization Name | DIVINE HEALTHCARE |
| Practice Address |
3856 Noble St Apt 1510 Jackson MS 39209-4949 |
| Practice Telephone | 7692167185 |
| Mailing Telephone | 7692167185 |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2014-12-09 |
| Authorized Official Name | MS. MAKEBA EVANS (OWNER) |
| Authorized Official Telephone | 7692167185 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255618716 | Divine Healthcare | Home Health | 903 Shaftoe St Nw, Kennesaw, GA 30152-6999 | 2011-11-11 |
| 1003433079 | Divine Healthcare | Nurse Practitioner | 9316 Spring House Ln Apt B, Laurel, MD 20708-4207 | 2020-06-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DIVINE HEALTHCARE CONSULTANTS LLC | 950 Marina Drive, Slidell, LA 70458-9209 |
| System for Award Management (SAM) Entities | DIVINE HEALTHCARE CONSULTING, LLC | 3821 Castleberry Dr, Tallahassee, FL 32303-2113 |
| System for Award Management (SAM) Entities | DIVINE HEALTHCARE SERVICES, LLC | 60 Evergreen Pl Ste 501, East Orange, NJ 07018-2118 |
| Street Address |
3856 NOBLE ST APT 1510 |
| City | JACKSON |
| State | MS |
| Zip Code | 39209-4949 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326477449 | Makeba Evans | Home Health Aide | 3856 Noble St Apt 1510, Jackson, MS 39209-4949 | 2013-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754995 | Oak Street Health Physicians Group of Mississippi, LLC | Family Medicine | 911 Ellis Ave, Jackson, MS 39209 | 2020-06-09 |
| 1760003594 | Phi Health, LLC | Ambulance | 582 Ramp Road, Suite C, Jackson, MS 39209 | 2020-05-04 |
| 1720468911 | Genoa Healthcare, LLC | Pharmacy | 3450 Highway 80 W Rm 68, Jackson, MS 39209 | 2015-06-03 |
| 1013302082 | Tiffany Griffin | Nurse Practitioner | 3450 Highway 80 West, Jackson, MS 39209 | 2015-04-06 |
| 1679961957 | Cassetta Shontae Mcgee | Emergency Medical Technician, Basic | 5326 Queen Eleanor Ln, Jackson, MS 39209 | 2015-01-08 |
| 1124381280 | Martin Solution | In Home Supportive Care | 917 West Ridge, Jackson, MS 39209 | 2012-06-22 |
| 1649533589 | Adrinnie M Martin | Contractor | 917 Westridge, Jackson, MS 39209 | 2012-06-15 |
| 1831423862 | Infinity House, Inc | In Home Supportive Care | 1042 Pecan Park Circle, Jackson, MS 39209 | 2009-09-23 |
| 1174751093 | Linda M Vance | Nurse Practitioner | 1000 Metrocenter Ste 105, Jackson, MS 39209 | 2009-06-30 |
| 1770729998 | Kim Hestle | Speech-Language Pathologist | 733 N. Flag Chapel Road, Jackson, MS 39209 | 2008-12-17 |
| Find all providers in zip 39209 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029930 | Just Like Family Home Care LLC | Home Health | 910 E Northside Dr # 910e, Jackson, MS 39206-5533 | 2020-10-05 |
| 1235743162 | Shymeka Bolden | Home Health | 405 Dewitt Ave, Jackson, MS 39203 | 2020-09-08 |
| 1023647955 | Jennifer Mcneil | Home Health | 5814 Clinton Blvd # 2b, Jackson, MS 39209-2807 | 2020-04-02 |
| 1326670977 | Tyesha Smith | Home Health | 200 Rebel Woods Dr, Jackson, MS 39212-3009 | 2020-02-11 |
| 1780230185 | Avis Caring Hands Home Service | Home Health | 1419 Cooks Ave, Jackson, MS 39212-4376 | 2019-08-13 |
| 1063073500 | Dorothy Jean Homes | Home Health | 1836 First Ave, Jackson, MS 39209-6345 | 2019-06-25 |
| 1750941027 | Rock Care Home Health, LLC | Home Health | 3130 E Jackson Blvd Ste B, Jackson, MO 63755-2957 | 2019-06-18 |
| 1417415548 | Serenity Home Health Care | Home Health | 283 Parks Rd, Jackson, MS 39212-9604 | 2019-03-07 |
| 1841762192 | All About You Care LLC | Home Health | 716 Tomlinson St, Jackson, MI 49203-2060 | 2018-12-27 |
| 1013489483 | Sarah Gillum | Home Health | 1127 Greenbriar St, Jackson, MS 39211-2735 | 2018-12-26 |
| Find all providers in JACKSON | ||||
Please comment or provide details below to improve the information on DIVINE HEALTHCARE.
| 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.