Healthcare Provider Details

I. General information

NPI: 1821943994
Provider Name (Legal Business Name): JD EXECUTIVE CARE STAFFING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6650 RIVERS AVE STE 100
NORTH CHARLESTON SC
29406-4809
US

IV. Provider business mailing address

507 FRONT ST UNIT 628
SUMMERVILLE SC
29486-7919
US

V. Phone/Fax

Practice location:
  • Phone: 843-896-8027
  • Fax:
Mailing address:
  • Phone: 843-896-8027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOVONA NICOLE SIMPKINS
Title or Position: OWNER
Credential:
Phone: 267-516-0131