STA-HOME HOSPICE (NPI# 1821145285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821145285 |
| Entity Type | Organization |
| Organization Name | STA-HOME HOSPICE |
| Practice Address |
406 Briarwood Dr Suite 500 Jackson MS 39206-3039 |
| Practice Telephone | 6019911933 |
| Practice Fax Number | 6019913343 |
| Mailing Telephone | 6019911933 |
| Mailing Fax Number | 6019913343 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2017-03-29 |
| Authorized Official Name | MR. GLENN D. WOOD (DIRECTOR OF COMPLIANCE) |
| Authorized Official Telephone | 6019565100 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | 023 | MS | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | BCBS OF MS | 000070004 | 01 |
| MS | 00770002 | 05 |
| Street Address |
406 BRIARWOOD DR SUITE 500 |
| City | JACKSON |
| State | MS |
| Zip Code | 39206-3039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164694675 | Crosby Dental Group | Dentist | 406 Briarwood Dr, Suite 401, Jackson, MS 39206-3039 | 2008-03-25 |
| 1003026345 | Graves Crawley Stubblefield Jr. | Internal Medicine | 406 Briarwood Dr, Jackson, MS 39206-3039 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023661824 | Latoya Lanette Trunell | Occupational Therapy Assistant | 787 East Northside Drive, Jackson, MS 39206 | 2019-07-20 |
| 1649839291 | Andrew Harris | Dentist | 4505 I-55 Frontage Rd. N, Jackson, MS 39206 | 2019-06-07 |
| 1679065916 | Savannah Lee Zachry | Physical Therapist | 5140 Galaxie Dr Ste 108, Jackson, MS 39206 | 2018-06-02 |
| 1669987723 | Harmony House Calls LLC | Nurse Practitioner | 5140 Galaxie Dr Ste 105, Jackson, MS 39206 | 2017-12-11 |
| 1841719903 | Yolanda Yvette Bell | Nurse Practitioner | 6064 Whitestone Rd, Jackson, MS 39206 | 2017-09-10 |
| 1760907117 | Anthony Brown Jr. | Physical Therapist | 5411 I-55 North, Jackson, MS 39206 | 2017-08-07 |
| 1114457132 | Ambric N Williams | Occupational Therapy Assistant | 6017 Whitestone Rd, Jackson, MS 39206 | 2017-06-13 |
| 1952835613 | Peak Chiropractic Care, LLC | Chiropractor | 4915 I-55 North, Suite 201b, Jackson, MS 39206 | 2017-04-19 |
| 1447798293 | Peterkin and Associates of Mississippi Inc | Community/Behavioral Health | 5155 Galaxie Drive, Suite F, Jackson, MS 39206 | 2017-02-01 |
| 1952844219 | Jennifer Penick | Counselor | 460 Briarwood Drive, Suite 510, Jackson, MS 39206 | 2016-11-18 |
| Find all providers in zip 39206 | ||||
| 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.