Extra Mile Homecare Services

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

EXTRA MILE HOMECARE SERVICES

Practice address

1121 Trotwood Ave Ste 2
Columbia, TN 38401-1803

Phone

(931) 223-8083

NPI assigned

Jun 4, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Keith Wysong

Title

Owner

Phone

(731) 217-5944

Specialties & licenses 1

Addresses

Other names 1

• Visiting Angels Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1104493543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 TROTWOOD AVE STE 2",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384011803",
            "telephone_number": "931-223-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 TROTWOOD AVE STE 2",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384011803",
            "telephone_number": "931-223-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTRA MILE HOMECARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A",
        "authorized_official_last_name": "WYSONG",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-217-5944",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwysong@visitingangels.com",
            "affiliation": "N",
            "endpointDescription": "owner email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1121 Trotwood Ave Ste 2",
            "city": "Columbia",
            "state": "TN",
            "country_code": "US",
            "postal_code": "384011803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Visiting Angels",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paula M Ervin North, PT PHYSICAL THERAPIS
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• Jeff S Falconbury, H.I.S.
• Nicole Margaret Falls, M.D.

• All providers in Columbia, TN
• In Home Supportive Care Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.