Impact Care Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

IMPACT CARE SERVICES LLC

Practice address

2020 Brice Rd Ste 185
Reynoldsburg, OH 43068-3484

Phone

(614) 600-5530

NPI assigned

Jan 24, 2022

Organization subpart

No

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

Authorized official

Name

Marc A Fequiere

Title

Administrator

Phone

(614) 370-8248

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1043962889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 BRICE RD STE 185",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430683484",
            "telephone_number": "614-600-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 BRICE RD STE 185",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430683484",
            "telephone_number": "614-600-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "FEQUIERE",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "614-370-8248"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.