NPIMap

Organization Active NPI

Tridentcare Health Services, Inc.

  • In Home Supportive Care Agency
  • Atlanta, GA
National Provider Identifier
1114280922
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
060-R-1032
Legal business name
TRIDENTCARE HEALTH SERVICES, INC.
Practice address
1200 Abernathy Rd NE
Building 600, Suite 1700
Atlanta, GA 30328-5662
Phone
(678) 514-7322
Fax
(678) 528-5076
NPI assigned
Jun 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Authorized official

Name
Mr. Vonstone Wolfe
Title
Chief Administrative Officer
Phone
(678) 514-7322

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 060-R-1032 Primary

Addresses

Primary practice location

1200 Abernathy Rd NE
Building 600, Suite 1700
Atlanta, GA 30328-5662

Mailing address

1200 Abernathy Rd NE
Building 600, Suite 1700
Atlanta, GA 30328-5662
Phone (678) 514-7322

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339977600000",
    "number": "1114280922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 ABERNATHY RD NE",
            "address_2": "BUILDING 600, SUITE 1700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285662",
            "telephone_number": "678-514-7322",
            "fax_number": "678-528-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ABERNATHY RD NE",
            "address_2": "BUILDING 600, SUITE 1700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285662",
            "telephone_number": "678-514-7322",
            "fax_number": "678-528-5076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIDENTCARE HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-18",
        "last_updated": "2012-06-18",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "VONSTONE",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "678-514-7322",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": "060-R-1032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; 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.