Epiphany Healthcare System, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

060-R-0322 Issued in GA

Legal business name

EPIPHANY HEALTHCARE SYSTEM, INC

Doing business as

Accessible Health Care of South Atlanta

Practice address

1015 Tyrone Rd Ste 110
Tyrone, GA 30290-2407

Phone

(770) 306-3416

Fax

(770) 306-3417

NPI assigned

Dec 27, 2007

Last updated

Aug 20, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Dickson Osanu, RN

Title

Administrator

Phone

(770) 306-3416

Specialties & licenses 2

Addresses

Other names 1

• Accessible Health Care of South Atlanta Doing business as

Tax ID family

Epiphany Healthcare System Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Epiphany Healthcare Systems, Inc

  dba Accessible Healthcare of South Atlanta

  • Mental Health Counselor
  • Union City, GA
  • NPI 1578013751
  NPD tax ID
• Epiphany Healthcare System, Inc

  • Mental Health Counselor
  • Hammond, LA
  • NPI 1730660176
  NPD tax ID

Locations

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534723200000",
    "number": "1124202973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 MALL BLVD",
            "address_2": "SUITE 518",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912044",
            "telephone_number": "770-306-3416",
            "fax_number": "770-306-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 TYRONE RD STE 110",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302902407",
            "telephone_number": "770-306-3416",
            "fax_number": "770-306-3417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "906 Fagan Drive",
            "address_2": "Bldg A. Suite 6A",
            "address_purpose": "LOCATION",
            "city": "Hammond",
            "state": "LA",
            "postal_code": "70403",
            "country_code": "US",
            "telephone_number": "985-956-7370",
            "fax_number": "985-956-7371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EPIPHANY HEALTHCARE SYSTEM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2018-08-20",
        "status": "A",
        "authorized_official_last_name": "OSANU",
        "authorized_official_first_name": "DICKSON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-306-3416",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "060-R-0322",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Accessible Health Care of South Atlanta",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Accessible Health Care of South Atlanta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Tyrone, GA
• Providers in Tyrone, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.