Organization Active NPI

Gifted Diversity Hands,LLC

  • Home Health Aide
  • Milwaukee, WI
National Provider Identifier
1235818980
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Legal business name
GIFTED DIVERSITY HANDS,LLC
Practice address
1728 W Wright St
Milwaukee, WI 53206-2043
Phone
(262) 696-9711
Fax
(262) 999-0150
NPI assigned
Jul 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Authorized official

Name
Shaquilla Renee Hannon, CARE PROVIDER
Title
Owner
Phone
(414) 552-3291

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X
Home Health AideGroup: 193200000X MULTI-SPECIALTY GROUP 374U00000X Primary
Respite Care 385H00000X

Addresses

Primary practice location

1728 W Wright St
Milwaukee, WI 53206-2043

Mailing address

3940 W Lisbon Ave Apt 310
Milwaukee, WI 53208-1883
Phone (414) 552-3291

Other identifiers 1

IdentifierTypeStateIssuer
17571MedicaidWI

National Provider Directory

National Provider Directory

Locations

8430 W Capitol Dr
Ste 3003F
Milwaukee, WI 53222

NPI Registry JSON

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1235818980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3940 W LISBON AVE APT 310",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532081883",
            "telephone_number": "414-552-3291",
            "fax_number": "262-999-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 W WRIGHT ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532062043",
            "telephone_number": "262-696-9711",
            "fax_number": "262-999-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIFTED DIVERSITY HANDS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-11",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "HANNON",
        "authorized_official_first_name": "SHAQUILLA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-552-3291",
        "authorized_official_credential": "CARE PROVIDER"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17571",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.