Distinctive Homecare LLC

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

Legal business name

DISTINCTIVE HOMECARE LLC

Practice address

9444 Kirkwood Rd
Philadelphia, PA 19114-2606

Phone

(267) 815-7307

NPI assigned

May 20, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Benjamin Degraft Koomson, RN

Title

President

Phone

(267) 815-7307

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589932800000",
    "number": "1013530443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9444 KIRKWOOD RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191142606",
            "telephone_number": "267-815-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9444 KIRKWOOD RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191142606",
            "telephone_number": "267-815-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINCTIVE HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-20",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A",
        "authorized_official_last_name": "DEGRAFT KOOMSON",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "267-815-7307",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Disston, CRNP
• Distar Inc.
• Molly Spencer Distefano, LICSW
• Nicholas Distefano, PHARMD
• Distinct Home Health Care, LLC.
• Joann Gallagher Ditalia
• Maria Isabella Dithomas, PA-C
• Frederick S Ditmars
• Robert A Ditomasso, PH.D.
• Michael Anthony Ditore, PMH-NP

• General Practice Registered Nurse in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.