NPIMap

Organization Active NPI

Genesis Medic

  • Home Health Agency
  • Anaheim, CA
National Provider Identifier
1245753136
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
95004382 Issued in CA
Legal business name
GENESIS MEDIC
Practice address
1091 S Matthew Way
Anaheim, CA 92808-1459
Phone
(714) 348-5631
NPI assigned
Jul 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Araba SackeyNPI 1093235699
Title
Director
Phone
(714) 348-5631

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 95004382 CA Primary
Community Health Clinic/Center 261QC1500X 95004382 CA

Addresses

Primary practice location

1091 S Matthew Way
Anaheim, CA 92808-1459

Mailing address

1091 S Matthew Way
Anaheim, CA 92808-1459
Phone (714) 348-5631

National Provider Directory

National Provider Directory

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": "1500595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1245753136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1091 S MATTHEW WAY",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928081459",
            "telephone_number": "714-348-5631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1091 S MATTHEW WAY",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928081459",
            "telephone_number": "714-348-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS MEDIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SACKEY",
        "authorized_official_first_name": "ARABA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "714-348-5631"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "95004382",
            "primary": true
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "95004382",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.