Organization Active NPI

Genesis Home Care LLC

  • Home Health Aide
  • Jonesboro, GA
National Provider Identifier
1104330554
Registry record updated Nov 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Legal business name
GENESIS HOME CARE LLC
Practice address
1228 Bonita Cir
Jonesboro, GA 30238-7882
Phone
(770) 875-7152
NPI assigned
Nov 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2017

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

Authorized official

Name
Mr. Brian D GreerNPI 1407278708
Title
Owner
Phone
(770) 808-6070

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
Home Health AideGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 374U00000X GA Primary

Addresses

Primary practice location

1228 Bonita Cir
Jonesboro, GA 30238-7882

Mailing address

3707 Main St
College Park, GA 30337-3544
Phone (770) 808-6070

National Provider Directory

National Provider Directory

Locations

3707 Main St
College Park, GA 30337
Phone (404) 483-5873

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": "1511222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511222400000",
    "number": "1104330554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 MAIN ST",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303373544",
            "telephone_number": "770-808-6070",
            "fax_number": "770-679-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 BONITA CIR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302387882",
            "telephone_number": "770-875-7152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-21",
        "last_updated": "2017-11-21",
        "status": "A",
        "authorized_official_last_name": "GREER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-808-6070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; 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.