NPIMap

Organization Active NPI

DRD Private Home Care

  • In Home Supportive Care Agency
  • Douglasville, GA
National Provider Identifier
1023823960
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
DRD PRIVATE HOME CARE
Practice address
7712 Autry Cir Apt 310
Douglasville, GA 30134-5730
Phone
(470) 276-4515
Fax
(470) 228-5106
NPI assigned
Feb 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Authorized official

Name
De'Shalah PotterNPI 1427901701
Title
Manager
Phone
(470) 412-0295

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary
Child Mental Illness Respite Care 385HR2055X
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X
Child Physical Disabilities Respite Care 385HR2065X

Addresses

Primary practice location

7712 Autry Cir Apt 310
Douglasville, GA 30134-5730

Mailing address

7712 Autry Cir Apt 310
Douglasville, GA 30134-5730
Phone (470) 276-4515

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747612800000",
    "number": "1023823960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7712 AUTRY CIR APT 310",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345730",
            "telephone_number": "470-276-4515",
            "fax_number": "470-228-5106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7712 AUTRY CIR APT 310",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345730",
            "telephone_number": "470-276-4515",
            "fax_number": "470-228-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRD PRIVATE HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "DE'SHALAH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "470-412-0295"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.