PROVIDENCE HOSPICE, LLC (NPI# 1548218738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548218738 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HOSPICE, LLC |
| Practice Address |
13 Northtown Dr Suite 220 Jackson MS 39211-3047 |
| Mailing Address |
13 Northtown Dr Jackson MS 39211-3047 |
| Practice Telephone | 6019569755 |
| Practice Fax Number | 6019560743 |
| Mailing Telephone | 6019569755 |
| Mailing Fax Number | 6019560743 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2007-12-18 |
| Authorized Official Name | MR. RICHARD E KEYES (MANAGING MEMBER) |
| Authorized Official Telephone | 6019569755 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | 090 | MS | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08734861 | 05 |
| Street Address |
13 NORTHTOWN DR SUITE 220 |
| City | JACKSON |
| State | MS |
| Zip Code | 39211-3047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093251845 | Reliant Medical Transportation, LLC | Ambulance | 13 Northtown Dr, Suite 130, Jackson, MS 39211-3047 | 2017-01-17 |
| 1891169496 | Quitman County Health & Rehab, LLC | Nursing Facility/Intermediate Care Facility | 13 Northtown Dr, Suite 220, Jackson, MS 39211-3047 | 2015-11-19 |
| 1598139248 | Tunica County Health & Rehab, LLC | Nursing Facility/Intermediate Care Facility | 13 Northtown Dr, Suite 220, Jackson, MS 39211-3047 | 2015-11-18 |
| 1932571296 | H & R Healthcare, LLC | Skilled Nursing Facility | 13 Northtown Dr, Suite 220, Jackson, MS 39211-3047 | 2015-10-27 |
| 1295174316 | Laura Catherine Weeks | Occupational Therapist | 13 Northtown Dr, Suite 110, Jackson, MS 39211-3047 | 2013-06-21 |
| 1902030026 | Sharon Gayle Magee | Occupational Therapist | 13 Northtown Dr, Suite 110, Jackson, MS 39211-3047 | 2009-05-04 |
| 1275727422 | Steven Patrick Moore | Physical Therapist | 13 Northtown Dr, Suite 110, Jackson, MS 39211-3047 | 2007-08-30 |
| 1184818577 | Danielle Marie Butkowski | Occupational Therapist | 13 Northtown Dr, Suite 110, Jackson, MS 39211-3047 | 2007-08-29 |
| 1881888279 | Alicia M Marlow | Speech-Language Pathologist | 13 Northtown Dr, Suite 110, Jackson, MS 39211-3047 | 2007-08-29 |
| 1306030796 | Paulette Owens Milligan | Occupational Therapy Assistant | 13 Northtown Dr, Suite 110, Jackson, MS 39211-3047 | 2007-08-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092878 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 5722 I-55 N Frontage Road, Jackson, MS 39211 | 2020-08-04 |
| 1548881048 | Gloria Dansby-giles | Counselor | 4500 Interstate 55, North; Suite 220, Jackson, MS 39211 | 2020-05-06 |
| 1821628223 | Alice Powell Taylor | St. Dominic Weight Loss Solutions, 3800 Interstate 55 North Frontage Road Suite 102, Jackson, MS 39211 | 2020-01-24 | |
| 1356980643 | Bethany Powers | Pharmacist | 4910 Interstate 55 North Frontage Rd, Jackson, MS 39211 | 2020-01-03 |
| 1316585581 | Deborah Magoun Rosenbaum | Pharmacist | [email protected], 4910 I-55 North, Jackson, MS 39211 | 2019-12-18 |
| 1285108357 | Eric Wood | Counselor | 4623 Maurey Rd, Jackson, MS 39211 | 2019-01-11 |
| 1649758301 | Isluv Robertson | Registered Nurse | 1405 E Northside Dr, Jackson, MS 39211 | 2018-08-03 |
| 1659863066 | Jonbrighton Childs Russell | Student in an Organized Health Care Education/Training Program | 4343 Dalrymple Ct, Jackson, MS 39211 | 2018-05-31 |
| 1225557598 | Regina Ann Day | Dietitian, Registered | 3800 I 55 North Frontage Road, Jackson, MS 39211 | 2017-09-18 |
| 1023558525 | Agilitas Usa Inc | Clinic/Center | 120 District Blvd E, Suite D102, Jackson, MS 39211 | 2017-03-02 |
| Find all providers in zip 39211 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992331128 | Careline Health Group - Mi LLC | Hospice Care, Community Based | 113 W Michigan Ave Ste 1024th, Jackson, MI 49201-1340 | 2020-03-19 |
| 1104357177 | Heart of Hospice, LLC | Hospice Care, Community Based | 135 Bounds St, Ste C, Jackson, MS 39206-4121 | 2017-03-22 |
| 1104211200 | Lhcg Lxvi, LLC | Hospice Care, Community Based | 308 E Pearl St, Suite 301, Jackson, MS 39201-3419 | 2015-04-06 |
| 1982945978 | At Home Hospice Care, Inc. | Hospice Care, Community Based | 5015 I 55 N, Ste A, Jackson, MS 39206-4306 | 2013-03-15 |
| 1811250269 | Allcare Hospice & Palliative Services LLC | Hospice Care, Community Based | 381 Edgewood Terrace Dr, Jackson, MS 39206-6217 | 2012-06-20 |
| 1548523186 | Hospice of Jackson - Hospice Home | Hospice Care, Community Based | 2150 Kingsbrooke Dr, Jackson, MI 49202-1300 | 2012-06-19 |
| 1003192477 | Creative Hospice Care, Inc | Hospice Care, Community Based | 791a Highway 36 E, Jackson, GA 30233-1792 | 2011-10-28 |
| 1548581499 | Perennial Hospice, Inc. | Hospice Care, Community Based | 5201 Cedar Park Dr, Suite D, Jackson, MS 39206-4140 | 2010-06-15 |
| 1881914711 | North Lion Hospice & Palliative Care, LLC | Hospice Care, Community Based | 135 Bounds Street, Suite C, Room 4, Jackson, MS 39206-4121 | 2010-06-02 |
| 1992027197 | Genesis Hospice Care, LLC | Hospice Care, Community Based | 135 Bounds St Ste C, Jackson, MS 39206-4121 | 2010-02-16 |
| Find all providers in JACKSON | ||||
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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.