Organization Active NPI

Assure Medical at Home, LLC

  • In Home Supportive Care Agency
  • Columbus, GA
National Provider Identifier
1104482504
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
ASSURE MEDICAL AT HOME, LLC
Practice address
1711 Buena Vista Rd Ste 2
Columbus, GA 31906-6141
Phone
(706) 641-2151
Fax
(706) 641-2171
NPI assigned
May 13, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Authorized official

Name
Conchetta Perry, FNP-CNPI 1093180234
Title
Owner
Phone
(706) 641-2151

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

1711 Buena Vista Rd Ste 2
Columbus, GA 31906-6141

Mailing address

1711 Buena Vista Rd Ste 2
Columbus, GA 31906-6141
Phone (706) 641-2151

Other identifiers 1

IdentifierTypeStateIssuer
003193515AMedicaidGA

National Provider Directory

National Provider Directory

Locations

1711 Buena Vista Rd
Ste 2
Columbus, GA 31906
Phone (706) 641-2151

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": "1557705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557705600000",
    "number": "1104482504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 BUENA VISTA RD STE 2",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319066141",
            "telephone_number": "706-641-2151",
            "fax_number": "706-641-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 BUENA VISTA RD STE 2",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319066141",
            "telephone_number": "706-641-2151",
            "fax_number": "706-641-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSURE MEDICAL AT HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-05-13",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "CONCHETTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-641-2151",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003193515A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.