NPI Code Detail JSON Logo

1437852266 NPI number — MILLENNIAL HEALTHCARE, LLC

NPI Number: 1437852266
Health Care Provider/Practitioner: MILLENNIAL HEALTHCARE, LLC

Information about “1437852266” NPI (MILLENNIAL HEALTHCARE, LLC) exists in 1437852266 in HTML format HTML  |  1437852266 in plain Text format TXT  |  1437852266 in PDF (Portable Document Format) PDF  |  1437852266 in an XML format XML  formats.

NPI Number : 1437852266 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1437852266",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MILLENNIAL HEALTHCARE, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "655 MEADOWBROOK RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JACKSON",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "39206-5842",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "601-882-4878",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5290 GALAXIE DR STE 105",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JACKSON",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39206-4311",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "601-882-4878",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/22/2023",
    "LastUpdateDate": "10/20/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BUCKNER",
    "AuthorizedOfficialFirstName": "DOMINIQUE",
    "AuthorizedOfficialMiddleName": "JAQUETTA NICOLE",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "601-882-4878",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "253Z00000X",
          "TaxonomyName": "In Home Supportive Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "343900000X",
          "TaxonomyName": "Non-emergency Medical Transport (VAN)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251J00000X",
          "TaxonomyName": "Nursing Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.