Individual provider Active NPI

Nicole Grippo-Leodis

  • In Home Supportive Care Agency
  • Fort Mill, SC
National Provider Identifier
1174976864
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Practice address
3041 Drewsky LN Unit 304
Fort Mill, SC 29715-0108
Phone
(908) 666-7170
NPI assigned
Jul 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary
Developmentally Disabled Services Day Training Agency 251C00000X

Addresses

Primary practice location

3041 Drewsky LN Unit 304
Fort Mill, SC 29715-0108

Mailing address

3041 Drewsky LN Unit 304
Fort Mill, SC 29715-0108
Phone (908) 666-7170

Other practice location 1

775 Brewers Bridge Rd
Apartment 21L
Jackson, NJ 08527-1975
Phone (908) 666-7170

Other practice location 2

775 Brewers Bridge Rd
Apartment 21L
Jackson, NJ 08527-1975
Phone (908) 666-7170

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

NPI Registry JSON

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1174976864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3041 DREWSKY LN UNIT 304",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297150108",
            "telephone_number": "908-666-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3041 DREWSKY LN UNIT 304",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297150108",
            "telephone_number": "908-666-7170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "775 Brewers Bridge Rd",
            "address_2": "Apartment 21L",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "NJ",
            "postal_code": "085271975",
            "country_code": "US",
            "telephone_number": "908-666-7170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "775 Brewers Bridge Rd",
            "address_2": "Apartment 21L",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "NJ",
            "postal_code": "085271975",
            "country_code": "US",
            "telephone_number": "908-666-7170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIPPO-LEODIS",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.