Active NPI
Dynamic Hospice of North Georgia, Inc.
- Community Based Hospice Care Agency
- Canton, GA
National Provider Identifier
1134740418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- DYNAMIC HOSPICE OF NORTH GEORGIA, INC.
- Practice address
- 1558 Marietta Hwy Ste 210
Canton, GA 30114-3615 - Phone
- (470) 259-0444
- NPI assigned
- Apr 28, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Darryl Robinson
- Title
- President
- Phone
- (313) 779-7685
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
1558 Marietta Hwy Ste 210
Canton, GA 30114-3615
Mailing address
PO Box 1303
Tucker, GA 30085-1303
Phone (313) 779-7685
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588032000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1591747200000",
"number": "1134740418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1303",
"city": "TUCKER",
"state": "GA",
"postal_code": "300851303",
"telephone_number": "313-779-7685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1558 MARIETTA HWY STE 210",
"city": "CANTON",
"state": "GA",
"postal_code": "301143615",
"telephone_number": "470-259-0444"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DYNAMIC HOSPICE OF NORTH GEORGIA, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2020-04-28",
"last_updated": "2020-06-10",
"certification_date": "2020-06-10",
"status": "A",
"authorized_official_last_name": "ROBINSON",
"authorized_official_first_name": "DARRYL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "313-779-7685",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.