METHODIST HOME ROAD LIVING CENTER (NPI# 1245663251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245663251 |
| Entity Type | Organization |
| Organization Name | METHODIST HOME ROAD LIVING CENTER |
| Practice Address |
4560 Methodist Home Road Jackson MS 39213 |
| Practice Telephone | 7692577232 |
| Practice Fax Number | 7692577745 |
| Mailing Telephone | 7692577232 |
| Mailing Fax Number | 7692577745 |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2013-08-13 |
| Authorized Official Name | MRS. PEBLES JONES-WRIGHT (MANAGER/OWNER) |
| Authorized Official Telephone | 7692577232 |
| Is Organization Subpart | Y |
| Parent Organization Name | METHODIST HOME ROAD LIVING CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | P321453 | MS | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | DUNS | 078890066 | 01 |
| Street Address |
4560 METHODIST HOME ROAD |
| City | JACKSON |
| State | MS |
| Zip Code | 39213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679117980 | Cynthia Bailey | Technician | 916 Carnation Street, Jackson, MS 39213 | 2019-10-30 |
| 1871136374 | Shirley Collins Williams | Technician | 3132 Sage St, Jackson, MS 39213 | 2019-10-28 |
| 1275057069 | Nikita Patel | Pharmacist | 830 West Woodrow Wilson Avenue, Jackson, MS 39213 | 2017-08-02 |
| 1346782893 | Mississippi Smiles Dentistry LLC | Dentist | 310 W Woodrow Wilson Ave, 400, Jackson, MS 39213 | 2016-11-15 |
| 1730637521 | Ms Eyecare Associates of Jackson, Pllc. | Optometrist | 310 West Woodrow Wilson Avenue Suite 300, Jackson, MS 39213 | 2016-09-21 |
| 1518410778 | Assurance Home Health Services, LLC | Health Maintenance Organization | 1771 Hamilton Blvd., Jackson, MS 39213 | 2016-07-25 |
| 1831576180 | Dorothy Jeffries Anderson | Counselor | 350 Woodrow Wilson Ave, Jackson, MS 39213 | 2015-05-06 |
| 1740697275 | Sincere Home Care LLC. | Chore Provider | 5911 Holmes Ct, Jackson, MS 39213 | 2014-07-16 |
| 1629401088 | Deborah Diane Wright | Assisted Living Facility | 5911 Holmes Court, Jackson, MS 39213 | 2013-08-20 |
| 1104197508 | Regan Doleac Spence | Nurse Practitioner | 350 West Woodrow Wilson, Jackson, MS 39213 | 2012-01-18 |
| Find all providers in zip 39213 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386272375 | Meagan Mary Deane | Licensed Practical Nurse | 1311 Winston Dr, Jackson, MI 49203-5026 | 2020-03-27 |
| 1952953390 | Kristin Marie Mees | Licensed Practical Nurse | 702 W Ganson St, Jackson, MI 49201-1047 | 2019-07-16 |
| 1477011336 | Roberta Lee Bentley | Licensed Practical Nurse | 5120 Leora Ln, Jackson, MI 49201-8912 | 2019-03-08 |
| 1033608385 | Suzann Swetland | Licensed Practical Nurse | 510 Gregory Pl, Jackson, MI 49202-2608 | 2018-05-02 |
| 1285122309 | Angela Holt | Licensed Practical Nurse | 913 Seymour Ave, Jackson, MI 49202-2543 | 2018-04-24 |
| 1093211377 | Sheldon Ewers | Licensed Practical Nurse | 5052 Marble St, Jackson, MI 49201-8146 | 2018-04-04 |
| 1508377383 | Coleman Care Givers LLC | Licensed Practical Nurse | 706 Hillmont Dr, Jackson, MS 39209-6003 | 2017-10-19 |
| 1609326263 | Regina Mcdaniel | Licensed Practical Nurse | 502 Mccarty Ln, Unit 5, Jackson, OH 45640-7020 | 2016-10-07 |
| 1023564366 | Rebecca Ashenfelter | Licensed Practical Nurse | 4715 Fox Valley Dr., 1a, Jackson, MI 49204 | 2016-08-28 |
| 1144673146 | Merrie Loar | Licensed Practical Nurse | 1410 Sherman Wood Dr, Jackson, MI 49201-8129 | 2016-07-14 |
| Find all providers in JACKSON | ||||
Please comment or provide details below to improve the information on METHODIST HOME ROAD LIVING CENTER.
| 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.