Individual provider Active NPI

Roberson Jean Philippe, PRIVATE HOME CARE

  • Nursing Care Agency
  • Atlanta, GA
National Provider Identifier
1144844374
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
Practice address
3340 Peachtree Rd NE Ste 1800
Atlanta, GA 30326-1064
Phone
(678) 596-3904
NPI assigned
Jun 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X
Personal Care Attendant 3747P1801X PHCP010709 GA
Nursing Care Agency 251J00000X Primary

Addresses

Primary practice location

3340 Peachtree Rd NE Ste 1800
Atlanta, GA 30326-1064

Mailing address

3340 Peachtree Rd NE Ste 1800
Atlanta, GA 30326-1064
Phone (678) 596-3904

Other identifiers 1

IdentifierTypeStateIssuer
82-4635716OtherGAIRS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PHCP010709GAMDPersonal Care Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
Comfort Zone Private Home Care LLC Current Accepting new patients

Locations

3340 Peachtree Rd NE
Ste 1800
Atlanta, GA 30326
Phone (404) 812-5396

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1144844374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 PEACHTREE RD NE STE 1800",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261064",
            "telephone_number": "678-596-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 PEACHTREE RD NE STE 1800",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261064",
            "telephone_number": "678-596-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIPPE",
        "first_name": "ROBERSON",
        "middle_name": "JEAN",
        "credential": "PRIVATE HOME CARE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "GA",
            "license": "PHCP010709",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "82-4635716",
            "state": "GA"
        }
    ],
    "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 Aug 5, 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.

Verify at the official NPI Registry.