PEGGY CLAYBORNE (NPI# 1689114233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689114233 |
| Entity Type | Individual |
| Full Name | PEGGY CLAYBORNE |
| Practice Address |
219 Ford Ave Jackson MS 39209-3322 |
| Mailing Address |
4795 Mcwillie Dr Suite 105 Jackson MS 39206-5628 |
| Practice Telephone | 6622997236 |
| Mailing Telephone | 7695244191 |
| Mailing Fax Number | 7695244208 |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
09603294 | MS | Nursing Service Related Providers |
| Street Address |
219 FORD AVE |
| City | JACKSON |
| State | MS |
| Zip Code | 39209-3322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184165169 | Alexander, Vincent & Alexandria LLC | Home Health | 219 Ford Ave, Jackson, MS 39209-3322 | 2017-03-10 |
| 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 | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
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| 1790385193 | Theresa Rouse | Technician | 640 Cutlip Rd, Jackson, OH 45640-9451 | 2020-10-27 |
| 1871190777 | Sandra Kay Dempsey | Technician | 110 Morton St, Jackson, OH 45640-1335 | 2020-10-04 |
| 1780293043 | Alyn Kristin Kay | Technician | Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 | 2020-07-23 |
| 1164063376 | Reginald Lumpkin | Technician | 1160 Joanne St Apt 108, Jackson, MS 39204-5253 | 2019-09-30 |
| 1770098295 | Angelica Ross | Technician | 128 Devonshire Sq, Jackson, TN 38305-2229 | 2017-12-06 |
| 1972032159 | Sherice Shunta Stutts-walker | Technician | 6451 Homewood Cir, Jackson, MS 39213-7814 | 2017-06-09 |
| 1669857363 | Marvina Wright | Technician | 5512 N Silverton St, Jackson, SC 29831-3170 | 2015-07-22 |
| 1104210657 | Lorrine Mayes | Technician | 2741 Teresa Dr, Jackson, MS 39212-2758 | 2015-03-23 |
| 1356734297 | Marilyn Loomis | Technician | 141 N Jackson St, Jackson, MI 49201-1201 | 2015-03-17 |
| 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.