NPIMap

Organization Active NPI

Idella's Angels

  • Adult Care Home Facility
  • Cairo, GA
National Provider Identifier
1114549763
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
IDELLA'S ANGELS
Practice address
270 13TH Ave SW
Cairo, GA 39828-3423
Phone
(229) 200-4887
NPI assigned
May 16, 2020
Last updated
Oct 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Authorized official

Name
Sharon Laverne Bennett
Title
Owner
Phone
(229) 200-4887

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU
Adult Care Home Facility 311ZA0620X NU Primary

Addresses

Primary practice location

270 13TH Ave SW
Cairo, GA 39828-3423

Mailing address

270 13TH Ave SW
Cairo, GA 39828-3423
Phone (229) 200-4887

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL ADDRESS
Direct Messaging Address williamscarter42@icloud.com Direct

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1589587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1114549763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 13TH AVE SW",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398283423",
            "telephone_number": "229-200-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 13TH AVE SW",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398283423",
            "telephone_number": "229-200-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDELLA'S ANGELS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-16",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "LAVERNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-200-4887"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ADDRESS",
            "affiliation": "N",
            "address_1": "270 13th Ave SW",
            "city": "Cairo",
            "state": "GA",
            "country_code": "US",
            "postal_code": "398283423",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "williamscarter42@icloud.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "270 13th Ave SW",
            "city": "Cairo",
            "state": "GA",
            "country_code": "US",
            "postal_code": "398283423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cairo, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.