NPIMap

Organization Active NPI

Sovereign Personal Services

  • In Home Supportive Care Agency
  • Snellville, GA
National Provider Identifier
1154563286
Registry record updated Apr 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
067-R-0533 Issued in GA
Legal business name
SOVEREIGN PERSONAL SERVICES
Practice address
2386 Clower St
BLDG D, Suite 100D
Snellville, GA 30078-6134
Phone
(678) 682-9121
Fax
(678) 935-0278
NPI assigned
Apr 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2009

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

Authorized official

Name
Mr. Jeffrey Allen Kelly
Title
Owner/Administrator
Phone
(678) 682-9121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 067-R-0533 GA Primary

Addresses

Primary practice location

2386 Clower St
BLDG D, Suite 100D
Snellville, GA 30078-6134

Mailing address

2386 Clower St
BLDG D, Suite 100D
Snellville, GA 30078-6134
Phone (678) 682-9121

Other names 1

  • Synergy HomeCare Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238976000000",
    "number": "1154563286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2386 CLOWER ST",
            "address_2": "BLDG D, SUITE 100D",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786134",
            "telephone_number": "678-682-9121",
            "fax_number": "678-935-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2386 CLOWER ST",
            "address_2": "BLDG D, SUITE 100D",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786134",
            "telephone_number": "678-682-9121",
            "fax_number": "678-935-0278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN PERSONAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-06",
        "last_updated": "2009-04-06",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "678-682-9121",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "067-R-0533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synergy HomeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.