NPIMap

Organization Active NPI

Kokua Community Services LLC

  • Home Health Agency
  • Fayetteville, GA
National Provider Identifier
1245057744
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
KOKUA COMMUNITY SERVICES LLC
Practice address
288 High Way 314
Suite C
Fayetteville, GA 30214
Phone
(470) 352-0524
NPI assigned
Sep 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Authorized official

Name
Nigel GauntlettNPI 1043010283
Title
Owner
Phone
(470) 352-0524

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
In Home Supportive Care Agency 253Z00000X

Addresses

Primary practice location

288 High Way 314
Suite C
Fayetteville, GA 30214

Mailing address

165 Keaton Dr
Fayetteville, GA 30215-2035

Other names 1

  • Synergy HomeCare of Fayetteville Ga LLC Doing business as

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1245057744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 KEATON DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302152035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 HIGH WAY 314",
            "address_2": "SUITE C",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "470-352-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOKUA COMMUNITY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "GAUNTLETT",
        "authorized_official_first_name": "NIGEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-352-0524"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synergy HomeCare of Fayetteville Ga LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.