MERVIS JACKSON-MOODIE (NPI# 1346602075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346602075 |
| Entity Type | Individual |
| Full Name | MERVIS JACKSON-MOODIE |
| Practice Address |
8424 Long Acre Dr Miramar FL 33025-2816 |
| Mailing Address |
19388 Nw 14th St Pembroke Pines FL 33029-3200 |
| Practice Telephone | 7865536164 |
| Mailing Telephone | 7865536164 |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-03-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 372600000X | Adult Companion | Nursing Service Related Providers |
| Street Address |
8424 LONG ACRE DR |
| City | MIRAMAR |
| State | FL |
| Zip Code | 33025-2816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538702329 | Ashley V Carter | Nutritionist | 3803 Sw 93rd Ave, Miramar, FL 33025 | 2019-10-24 |
| 1477024305 | Jeff Rocker | Counselor | 10700 City Center Blvd Apt 5245, Pembroke Pines, FL 33025 | 2018-12-17 |
| 1760959779 | Spring Health Inc | In Home Supportive Care | 1799 Sw 82nd Pl, Miramar, FL 33025 | 2018-10-28 |
| 1649763004 | Ann-marie Elizabeth Pryce | Nurse Practitioner | 8942 Sw 19th St, Miramar, FL 33025 | 2018-06-11 |
| 1588154876 | Michelle Angelle Crawford | Behavior Technician | 10630 Washington St Apt 103, Pembroke Pines, FL 33025 | 2018-05-14 |
| 1598267809 | Lydia Rosa Malcolm | Psychologist | 11820 Miramar Pkwy Ste 309, Miramar, FL 33025 | 2018-03-02 |
| 1447760657 | At Talitha Cumi Home Care, Inc. | Homemaker | 3140 Sw 120 Terr, Miramar, FL 33025 | 2017-10-03 |
| 1962924522 | Yenni Celina Cueto | Behavioral Analyst | 720 Sw 111th Ave Apt 303, Pembroke Pines, FL 33025 | 2017-07-14 |
| 1093236713 | Manoucheca Fabienne Phanord | Nurse Practitioner | 11575 City Hall Promenade, #4-150, Miramar, FL 33025 | 2017-07-03 |
| 1659801439 | Desiree Verina Nugent | Family Medicine | 3772 Sw 93rd Ave, Miramar, FL 33025 | 2017-06-14 |
| Find all providers in zip 33025 | ||||
| Taxonomy Code | 372600000X |
| Grouping | Nursing Service Related Providers |
| Classification | Adult Companion |
| An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871192419 | Nyesha Isons | Adult Companion | 4835 48th St W Apt 513, Bradenton, FL 34210-2862 | 2020-10-24 |
| 1215536305 | Yolanda M Orr | Adult Companion | 1401 Marathon Key Dr Apt 103, Tampa, FL 33612-3650 | 2020-10-20 |
| 1871192187 | Yterria Mcgee | Adult Companion | 1202 N 29th St Apt 93, Fort Pierce, FL 34947-2230 | 2020-10-19 |
| 1316545544 | Hero Senior Care LLC | Adult Companion | 5231 Sw 152nd Ct, Miami, FL 33185-4110 | 2020-10-10 |
| 1821696089 | Audriana Clark | Adult Companion | 7333 Pine Forest Rd Lot 70, Pensacola, FL 32526-3910 | 2020-10-10 |
| 1154937969 | Lashonda Grice Velazquez | Adult Companion | 702 N 19th St, Palatka, FL 32177-3070 | 2020-09-17 |
| 1245845379 | Lameka Williams | Adult Companion | 6854 Cartier Cir, Jacksonville, FL 32208 | 2020-09-15 |
| 1447865639 | Yaimara Cruz | Adult Companion | 14400 Sw 79th Ct, Palmetto Bay, FL 33158-2019 | 2020-09-14 |
| 1275148082 | Latangela Shonta Vassel | Adult Companion | 1104 Bartow Rd Apt N163, Lakeland, FL 33801-5826 | 2020-09-09 |
| 1235743147 | Quanteria Mccaskill | Adult Companion | 116 Little Acres Dr, Palatka, FL 32177-4137 | 2020-09-08 |
| Find all providers with the same taxonomy | ||||
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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.