ODOMS TLC HOMECARE SERVICE (NPI# 1063045094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063045094 |
| Entity Type | Organization |
| Organization Name | ODOMS TLC HOMECARE SERVICE |
| Practice Address |
1600 Lansdowne Dr Apt 609 Jacksonville FL 32211-9010 |
| Practice Telephone | 9043622487 |
| Mailing Telephone | 9043622487 |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2020-02-18 |
| Authorized Official Name | LOLITA BURNNETT ELLIS (MEDICAID PROVIDER) |
| Authorized Official Telephone | 9043622487 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 376K00000X | Nurse's Aide | Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 024241200 | 05 | |
| FL | 10179500 | 05 |
| Other Name | Type Code |
|---|---|
| ODOMS TLC HOMECARE SERVICE | Doing Business As Name - Organization |
| Street Address |
1600 LANSDOWNE DR APT 609 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32211-9010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457951758 | Ebs Childrens Therapy - Fl LLC | Behavioral Analyst | 5491 Dolphin Point Blvd, Jacksonville, FL 32211 | 2020-10-27 |
| 1700412822 | Marie Vernal | Social Worker | 6051 Arlington Expressway Suite 169, Jacksonville, FL 32211 | 2020-03-20 |
| 1992336895 | Dolphin Pointe Health Care, LLC | Skilled Nursing Facility | 5355 Dolphin Point Rd., Jacksonville, FL 32211 | 2020-01-29 |
| 1366089641 | Prophetic Healing Deliverance Ministry of Mysteries, Inc | Counselor | 8550-2 Lone Star Road, Jacksonville, FL 32211 | 2019-12-05 |
| 1922656370 | Timothy Richard Barron | Behavior Technician | 5633 Clifton Ln, Jacksonville, FL 32211 | 2019-08-29 |
| 1023583325 | Linnzi Marks | Behavioral Analyst | 6014 Wateredge Ln, Jacksonville, FL 32211 | 2018-10-12 |
| 1780160192 | Ganesh Healthcare of Jax LLC | Alzheimer Center (Dementia Center) | 644 Cesery Blvd Ste 150, Jacksonville, FL 32211 | 2018-07-18 |
| 1902397276 | Chandra Harris Washington | In Home Supportive Care | 2712 Gaillardia Rd, Jacksonville, FL 32211 | 2018-05-22 |
| 1043730062 | Monica R Iskander | Dentist | 465 University Blvd N, Jacksonville, FL 32211 | 2017-06-21 |
| 1205366895 | Lilibeth Bundang Adona | Custodial Care Facility | 1818 Townsend Blvd, Jacksonville, FL 32211 | 2017-06-15 |
| Find all providers in zip 32211 | ||||
| Taxonomy Code | 376K00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Nurse's Aide |
| (1) An unlicensed individual who is trained to function in an assistive role to the licensed nurse in the provision of patient/client activities as delegated by the nurse; (2) An individual trained (either on-the-job or through a formal course generally of less than one year) and experienced in performing patient or client-care nursing tasks that do not require the skills of a specialist, technician, or professional. Examples of tasks performed by nurses aides include changing clothes, diapers, and beds; assisting patients to perform exercises or personal hygiene tasks, and supporting communication or social interaction. Specific education and credentials are not required for this work. |
| Notes: Source: (1) American Nurses Association, Registered Professional Nurses and Unlicensed Personnel, 2nd ed., 1996; (2) 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 |
|---|---|---|---|---|
| 1063013647 | Tia Patterson | Nurse's Aide | 9415 Devonshire Blvd, Jacksonville, FL 32208-7002 | 2020-11-02 |
| 1205433943 | Shannon Ethridge | Nurse's Aide | 3006 Ribault Scenic Dr, Jacksonville, FL 32208-2477 | 2020-10-06 |
| 1497366488 | Christina L Roberts | Nurse's Aide | 6028 Chester Ave Ste 206d, Jacksonville, FL 32217-2285 | 2020-08-12 |
| 1174133052 | Taylor K Wallace | Nurse's Aide | 13525 Bartram Park Blvd Unit 1538, Jacksonville, FL 32258-5271 | 2020-08-05 |
| 1861001745 | Jessica Michelle Mccree Braddy | Nurse's Aide | 8942 8th Ave, Jacksonville, FL 32208-2142 | 2020-07-28 |
| 1124636154 | Tamra Coffee Mikell | Nurse's Aide | 2875 Tate Ct, Jacksonville, FL 32218-8873 | 2020-07-15 |
| 1063033793 | Toilicia Danielle Sylvia Walker | Nurse's Aide | 239 E 43rd St, Jacksonville, FL 32208-5306 | 2020-05-05 |
| 1396366753 | Angel Taylor | Nurse's Aide | 6316 Solandra Dr, Jacksonville, FL 32210-7208 | 2020-04-27 |
| 1124647672 | Lapatra Fisher | Nurse's Aide | 7452 John F Kennedy Dr W, Jacksonville, FL 32219-3516 | 2020-04-15 |
| 1013541531 | Monica Mccutchen | Nurse's Aide | 5556 Ashleigh Park Dr, Jacksonville, FL 32244-7832 | 2020-02-24 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32211 |
Please comment or provide details below to improve the information on ODOMS TLC HOMECARE SERVICE.
| 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.