Organization Active NPI

Southern Home Care Assistance

  • In Home Supportive Care Agency
  • Hot Springs, AR
National Provider Identifier
1114390861
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
SOUTHERN HOME CARE ASSISTANCE
Practice address
2836 Malvern Ave Ste G
Hot Springs, AR 71901-8363
Phone
(501) 525-8886
NPI assigned
Nov 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Authorized official

Name
Stacey R Philyaw
Title
Office Manager
Phone
(501) 525-8886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

2836 Malvern Ave Ste G
Hot Springs, AR 71901-8363

Mailing address

2836 Malvern Ave Ste G
Hot Springs, AR 71901-8363
Phone (501) 525-8886

Other identifiers 1

IdentifierTypeStateIssuer
206214797MedicaidAR

National Provider Directory

National Provider Directory
Tax ID family
Southern Home Care Assistance2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446508800000",
    "number": "1114390861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2836 MALVERN AVE STE G",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719018363",
            "telephone_number": "501-525-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2836 MALVERN AVE STE G",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719018363",
            "telephone_number": "501-525-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN HOME CARE ASSISTANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-03",
        "last_updated": "2015-11-03",
        "status": "A",
        "authorized_official_last_name": "PHILYAW",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "501-525-8886"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206214797",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.