Healthcare Provider Details

I. General information

NPI: 1205781564
Provider Name (Legal Business Name): SHAMA HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 S ILLINOIS AVE STE 208
OAK RIDGE TN
37830-6220
US

IV. Provider business mailing address

136 S ILLINOIS AVE STE 208
OAK RIDGE TN
37830-6220
US

V. Phone/Fax

Practice location:
  • Phone: 865-320-8467
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SIMONE HIXSON
Title or Position: OWNER
Credential: LPN
Phone: 865-414-0458