NPIMap

Organization Active NPI

CC Home Care LLC

  • In Home Supportive Care Agency
  • Philadelphia, PA
National Provider Identifier
1033768528
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
CC HOME CARE LLC
Practice address
1102 W Somerville Ave
Philadelphia, PA 19141-2904
Phone
(267) 331-5253
NPI assigned
Sep 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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

Authorized official

Name
Medith CharlesNPI 1861256505
Title
Owner/President
Phone
(267) 304-6775

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

1102 W Somerville Ave
Philadelphia, PA 19141-2904

Mailing address

9713 Berea St
Philadelphia, PA 19114-1723

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1567728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567728000000",
    "number": "1033768528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9713 BEREA ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 W SOMERVILLE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191412904",
            "telephone_number": "267-331-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CC HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-06",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "MEDITH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "267-304-6775"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.