Active NPI
Dewaun Rockingham
- Home Health Agency
- Indianapolis, IN
National Provider Identifier
1104536572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 3902 N College Ave
Indianapolis, IN 46205-2735 - Phone
- (317) 507-6669
- NPI assigned
- Nov 28, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
3902 N College Ave
Indianapolis, IN 46205-2735
Mailing address
3902 N College Ave
Indianapolis, IN 46205-2735
Phone (317) 507-6669
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22-000808-1 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | RTRans24_7@yahoo.com | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669593600000",
"number": "1104536572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3902 N COLLEGE AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462052735",
"telephone_number": "317-507-6669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3902 N COLLEGE AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462052735",
"telephone_number": "317-507-6669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROCKINGHAM",
"first_name": "DEWAUN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-11-28",
"last_updated": "2022-11-28",
"certification_date": "2022-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "22-000808-1",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "RTRans24_7@yahoo.com",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Homecare Management",
"address_1": "3902 N College Ave",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462052735",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.