Provider Demographics
NPI:1770864290
Name:JEMASSIE INCORPORATED
Entity Type:Organization
Organization Name:JEMASSIE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHENITA
Authorized Official - Middle Name:RENEA
Authorized Official - Last Name:COLSON
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, MBA/MHA, CCM,
Authorized Official - Phone:704-399-3555
Mailing Address - Street 1:PO BOX 681421
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-0025
Mailing Address - Country:US
Mailing Address - Phone:704-399-3555
Mailing Address - Fax:
Practice Address - Street 1:1942 PHEASANT GLEN RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28214-8209
Practice Address - Country:US
Practice Address - Phone:704-399-3555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC194810163WA2000X, 163WC0400X, 163WC1500X, 163WH0200X, 163WH0500X, 251B00000X, 251E00000X, 251J00000X, 251S00000X, 313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Single Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysisGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
No251J00000XAgenciesNursing CareGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty