Provider Demographics
NPI:1760751465
Name:MICHAEL D. JESSEE
Entity Type:Organization
Organization Name:MICHAEL D. JESSEE
Other - Org Name:HOMEBOUND SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:JESSEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-500-1177
Mailing Address - Street 1:841 GIBBS LN
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-9435
Mailing Address - Country:US
Mailing Address - Phone:615-500-1177
Mailing Address - Fax:615-461-8702
Practice Address - Street 1:841 GIBBS LN
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-9435
Practice Address - Country:US
Practice Address - Phone:615-500-1177
Practice Address - Fax:615-461-8702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-26
Last Update Date:2011-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00006842332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH445185Medicaid