NICOLE JEFFERSON (NPI# 1174023063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174023063 |
| Entity Type | Individual |
| Full Name | NICOLE JEFFERSON |
| Practice Address |
311 Spring Dr Kyle TX 78640-5775 |
| Practice Telephone | 2542894071 |
| Practice Fax Number | 5122565978 |
| Mailing Telephone | 2542894071 |
| Mailing Fax Number | 5122565978 |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2020-10-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
Ambulatory Health Care Facilities | ||
| N | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities | ||
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities | ||
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | Residential Treatment Facilities | ||
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053934257 | Nicole Jefferson | Occupational Therapist | 1306 Baron Ct, Valparaiso, IN 46383-4479 | 2020-05-21 |
| 1396074423 | Nicole Jefferson | Home Health | 3240 Waterford Ct Apt 1305, Rochester Hills, MI 48309-2775 | 2009-12-20 |
| 1578052239 | Nicole L Jefferson | Physical Therapist | 3242 20th St S, Fargo, ND 58104 | 2018-05-08 |
| Street Address |
311 SPRING DR |
| City | KYLE |
| State | TX |
| Zip Code | 78640-5775 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558909853 | Advanced Spine & Wellness LLC | Chiropractor | 1101 Bunton Creek Rd., Ste. 330, Kyle, TX 78640 | 2019-12-17 |
| 1154962587 | Shelbi Hancock | Behavior Technician | 4221 Benner Road, Building 2, Suite 250, Kyle, TX 78640 | 2019-10-07 |
| 1326696469 | Robin Corina Dean | Physical Therapist | 21195b Ih35n Ste 201, Kyle, TX 78640 | 2019-09-02 |
| 1417503798 | Judson Sturdivant | Durable Medical Equipment & Medical Supplies | 1101 Bunton Creek Road, Kyle, TX 78640 | 2019-08-13 |
| 1063974152 | Fearless Functional Fitness, LLC | Physical Therapist | 140 Kirkham Circle, Kyle, TX 78640 | 2019-04-05 |
| 1639649197 | Virginia Vela | Nurse Practitioner | 180 Orion Cove, Kyle, TX 78640 | 2018-11-27 |
| 1033691878 | Keshavi Patel Pllc | Clinic/Center | 22510 Ih-35, Suite 104, Kyle, TX 78640 | 2018-08-29 |
| 1720564669 | Deborah Ann Burks | Massage Therapist | 147 Elmhurst Dr., 147 Elmhurst Dr. Ste 700, Kyle, TX 78640 | 2018-07-13 |
| 1689165995 | Daybreak Counseling Pllc | Counselor | 261 Mistletoe Ln, Kyle, TX 78640 | 2018-05-22 |
| 1194229179 | Amalia Belle Miller | Social Worker | 271 Hutton, Kyle, TX 78640 | 2018-03-22 |
| Find all providers in zip 78640 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255976973 | Caremeridian, LLC | Residential Treatment Facility, Physical Disabilities | 2301 W Campbell Rd, Garland, TX 75044-2846 | 2019-11-18 |
| 1376192823 | Jackie D Henderson | Residential Treatment Facility, Physical Disabilities | 7041 Hedgebrook Dr, Dallas, TX 75249 | 2019-09-07 |
| 1992272082 | Harmony Care Center | Residential Treatment Facility, Physical Disabilities | 4953 E Ridge Creek Dr, Houston, TX 77053-4638 | 2018-10-27 |
| 1558867747 | Maison De Spiritus, Inc. | Residential Treatment Facility, Physical Disabilities | 4122 Mainer St, Houston, TX 77021-5803 | 2018-04-05 |
| 1609382068 | Living Single LLC | Residential Treatment Facility, Physical Disabilities | 809 E. Denton Street, Ennis, TX 75119 | 2017-12-21 |
| 1356857213 | Cns - Houston, LLC | Residential Treatment Facility, Physical Disabilities | 253 W Medical Center Blvd Ste 300, Webster, TX 77598-4213 | 2017-12-14 |
| 1811433329 | Tasha Toliver | Residential Treatment Facility, Physical Disabilities | 2023 Laura St, Caddo Mills, TX 75135-7502 | 2017-01-09 |
| 1982153383 | Beacon Home Healthcare LLC | Residential Treatment Facility, Physical Disabilities | 2000 Summercrest Cv, Round Rock, TX 78681-1097 | 2016-09-26 |
| 1700239118 | Casa De Bellamie, LLC | Residential Treatment Facility, Physical Disabilities | 7235 N Loop Dr, El Paso, TX 79915-2412 | 2016-07-20 |
| 1023464245 | Emedtech Equipment and Supply Company | Residential Treatment Facility, Physical Disabilities | 5220 E Parkway Dr, Beaumont, TX 77705-6039 | 2016-05-05 |
| 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.