Active NPI
Umbrella Healthcare, LLC
- Community/Behavioral Health Agency
- Conyers, GA
National Provider Identifier
1104244482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- UMBRELLA HEALTHCARE, LLC
- Practice address
- 2141 Smyrna Rd SW
SW
Conyers, GA 30094-6168 - Phone
- (336) 382-9618
- NPI assigned
- Apr 2, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Derrick McDow
- Title
- Ceo
- Phone
- (336) 382-9618
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
2141 Smyrna Rd SW
SW
Conyers, GA 30094-6168
Mailing address
2141 Smyrna Rd SW
SW
Conyers, GA 30094-6168
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396396800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1396396800000",
"number": "1104244482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2141 SMYRNA RD SW",
"address_2": "SW",
"city": "CONYERS",
"state": "GA",
"postal_code": "300946168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2141 SMYRNA RD SW",
"address_2": "SW",
"city": "CONYERS",
"state": "GA",
"postal_code": "300946168",
"telephone_number": "336-382-9618"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UMBRELLA HEALTHCARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-04-02",
"last_updated": "2014-04-02",
"status": "A",
"authorized_official_last_name": "MCDOW",
"authorized_official_first_name": "DERRICK",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "336-382-9618"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.