NPIMap

Organization Active NPI

Agnes Elderly Care Sitter Services Agency

  • In Home Supportive Care Agency
  • Augusta, GA
National Provider Identifier
1144595596
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
17665 Issued in SC
Legal business name
AGNES ELDERLY CARE SITTER SERVICES AGENCY
Practice address
3517 Brockdale Dr
Augusta, GA 30906-8991
Phone
(706) 922-7993
NPI assigned
Mar 19, 2012
Last updated
Mar 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Authorized official

Name
Mr. Bernard Edward McRae
Title
Owner/Administrator
Phone
(706) 504-2380

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X LCB20120000162 GA
In Home Supportive Care Agency 253Z00000X 17665 SC Primary

Addresses

Primary practice location

3517 Brockdale Dr
Augusta, GA 30906-8991

Mailing address

3517 Brockdale Dr
Augusta, GA 30906-8991
Phone (706) 922-7993

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332115200000",
    "number": "1144595596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3517 BROCKDALE DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309068991",
            "telephone_number": "706-922-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3517 BROCKDALE DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309068991",
            "telephone_number": "706-922-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGNES ELDERLY CARE SITTER SERVICES AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-19",
        "last_updated": "2012-03-19",
        "status": "A",
        "authorized_official_last_name": "MCRAE",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "706-504-2380",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "LCB20120000162",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "SC",
            "license": "17665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.