Organization Active NPI

Private Home Care Provider LLC

  • In Home Supportive Care Agency
  • Atlanta, GA
National Provider Identifier
1114782505
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
PRIVATE HOME CARE PROVIDER LLC
Practice address
342 Marietta St NW Apt 10
Atlanta, GA 30313-1645
Phone
(404) 273-8545
NPI assigned
Feb 15, 2024
Last updated
Feb 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Authorized official

Name
Tony Jones
Title
Ceo
Phone
(404) 273-8545

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

342 Marietta St NW Apt 10
Atlanta, GA 30313-1645

Mailing address

342 Marietta St NW Apt 10
Atlanta, GA 30313-1645
Phone (404) 273-8545

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1114782505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 MARIETTA ST NW APT 10",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303131645",
            "telephone_number": "404-273-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 MARIETTA ST NW APT 10",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303131645",
            "telephone_number": "404-273-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE HOME CARE PROVIDER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-273-8545"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "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 Feb 15, 2024; 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.