Organization Active NPI

Care24Group LLC

Doing business as Shepherds Staff

  • In Home Supportive Care Agency
  • Frederick, MD
National Provider Identifier
1215798095
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
CARE24GROUP LLC
Doing business as
Shepherds Staff
Practice address
205 Broadway St Ste 210
Frederick, MD 21701-6761
Phone
(301) 304-9147
NPI assigned
Jan 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Authorized official

Name
Mr. Tadiwa Titus Young
Title
Vice President, Cfo
Phone
(571) 492-1603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

205 Broadway St Ste 210
Frederick, MD 21701-6761

Mailing address

205 Broadway St Ste 210
Frederick, MD 21701-6761
Phone (301) 304-9147

Other names 1

  • Shepherds Staff Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2345664Care24Group LLC Dba Shepherds Staff205 Broadway St #205, Frederick, MD 21701Certificate of waiverJun 15, 2028

National Provider Directory

National Provider Directory

Locations

205 Broadway St
Ste 210
Frederick, MD 21701
Phone (301) 304-9147

NPI Registry JSON

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1215798095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BROADWAY ST STE 210",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016761",
            "telephone_number": "301-304-9147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BROADWAY ST STE 210",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016761",
            "telephone_number": "301-304-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE24GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "TADIWA",
        "authorized_official_middle_name": "TITUS",
        "authorized_official_title_or_position": "VICE PRESIDENT, CFO",
        "authorized_official_telephone_number": "571-492-1603",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shepherds Staff",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.