Essential Embodiment LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

4272017 Issued in CO

Legal business name

ESSENTIAL EMBODIMENT LLC

Practice address

120 W Main St
Suite D
Cedaredge, CO 81413

Phone

(970) 808-1122

NPI assigned

May 3, 2017

Organization subpart

No

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

Authorized official

Name

Tins Marie Swoffer

Title

Owner

Phone

(970) 778-9663

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493769600000",
    "number": "1245766716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST",
            "address_2": "SUITE D",
            "city": "CEDAREDGE",
            "state": "CO",
            "postal_code": "81413",
            "telephone_number": "970-808-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST",
            "address_2": "SUITE D",
            "city": "CEDAREDGE",
            "state": "CO",
            "postal_code": "81413",
            "telephone_number": "970-808-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIAL EMBODIMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-03",
        "last_updated": "2017-05-03",
        "status": "A",
        "authorized_official_last_name": "SWOFFER",
        "authorized_official_first_name": "TINS",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-778-9663"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "CO",
            "license": "12181974",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "CO",
            "license": "4272017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4272017",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; 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.