Active NPI
Assure Medical at Home, LLC
- In Home Supportive Care Agency
- Columbus, GA
National Provider Identifier
1104482504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Conchetta Perry, FNP-C
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003193515A | Medicaid | GA |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Family Nurse Practitioner
- Columbus, GA
- NPI 1093180234
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.