Care at Home LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

CARE AT HOME LLC

Practice address

717 Washington Park Blvd
Michigan City, IN 46360-2056

Phone

(219) 229-1630

NPI assigned

Apr 4, 2019

Last updated

Apr 4, 2019By 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

Mrs. Raelonda M Woodard, FNP-BC

Title

President

Phone

(219) 229-1630

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1164984597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 WASHINGTON PARK BLVD",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463602056",
            "telephone_number": "219-229-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 WASHINGTON PARK BLVD",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463602056",
            "telephone_number": "219-229-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE AT HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "RAELONDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-229-1630",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386960599",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "raelondawoodard@protonmail.com",
            "affiliation": "N",
            "endpointDescription": "Private secured email via proton mail",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "717 Washington Park Blvd",
            "city": "Michigan City",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463602056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Primary Care Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; 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.