Gahanna Home Healthcare Agency, LLC

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

NA0008184328 Issued in NJ

Legal business name

GAHANNA HOME HEALTHCARE AGENCY, LLC

Practice address

7451 Bunker Ridge CT
Blacklick, OH 43004

Phone

(732) 766-9112

NPI assigned

Jul 28, 2017

Last updated

Jul 28, 2017By 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

Jamila A. Idris, CNA

Title

Business Manager

Phone

(732) 877-9776

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501200000000",
    "number": "1134643471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7451 BUNKER RIDGE CT",
            "city": "BLACKLICK",
            "state": "OH",
            "postal_code": "43004",
            "telephone_number": "732-766-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7451 BUNKER RIDGE CT",
            "city": "BLACKLICK",
            "state": "OH",
            "postal_code": "43004",
            "telephone_number": "732-766-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAHANNA HOME HEALTHCARE AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-28",
        "last_updated": "2017-07-28",
        "status": "A",
        "authorized_official_last_name": "IDRIS",
        "authorized_official_first_name": "JAMILA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "732-877-9776",
        "authorized_official_credential": "CNA"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NJ",
            "license": "NA0008184328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Registered Nurse in Blacklick, OH
• Providers in Blacklick, OH by specialty
• Home Health Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2017; 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.