NPIMap

Organization Active NPI

Affinity Home Care, Inc

  • In Home Supportive Care Agency
  • Vidalia, LA
National Provider Identifier
1104195338
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
15521 Issued in LA
Legal business name
AFFINITY HOME CARE, INC
Practice address
205 Carter St
Vidalia, LA 71373-3303
Phone
(318) 336-3300
Fax
(318) 336-9005
NPI assigned
Dec 16, 2011
Last updated
Dec 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

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

Authorized official

Name
Mrs. Josephine Johnson Hawkins, R.N.
Title
Executive Director
Phone
(318) 336-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 15521 LA Primary

Addresses

Primary practice location

205 Carter St
Vidalia, LA 71373-3303

Mailing address

PO Box 1215
Vidalia, LA 71373-1215
Phone (318) 336-3300

Other identifiers 1

IdentifierTypeStateIssuer
2166867MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Affinity Home Care Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323993600000",
    "number": "1104195338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1215",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713731215",
            "telephone_number": "318-336-3300",
            "fax_number": "318-336-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 CARTER ST",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713733303",
            "telephone_number": "318-336-3300",
            "fax_number": "318-336-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFINITY HOME CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-16",
        "last_updated": "2011-12-16",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "JOSEPHINE",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "318-336-3300",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "LA",
            "license": "15521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2166867",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; 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.