Healthcare Provider Details

I. General information

NPI: 1053239806
Provider Name (Legal Business Name): JSEAN JERMIANE THOMAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3411 DECATUR ST
OMAHA NE
68111-4143
US

IV. Provider business mailing address

3411 DECATUR ST
OMAHA NE
68111-4143
US

V. Phone/Fax

Practice location:
  • Phone: 531-225-4223
  • Fax:
Mailing address:
  • Phone: 531-225-4223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: