Impact Care, LLC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

IMPACT CARE, LLC

Practice address

15325 Gratiot Ave
Detroit, MI 48205-1328

Phone

(877) 544-6722

NPI assigned

Feb 23, 2024

Last updated

Feb 23, 2024By 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

Danielle L Johnson, B.A. , CHWNPI 1912763376

Title

Owner/Director

Phone

(877) 544-6722

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Danielle Lynette Johnson, B.A. CHW

  • Community Health Worker
  • Detroit, MI
  • NPI 1912763376
  NPD Authorized official

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1154187524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15325 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482051328",
            "telephone_number": "877-544-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15325 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482051328",
            "telephone_number": "877-544-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "877-544-6722",
        "authorized_official_credential": "B.A. , CHW"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Community Health Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.