Divine Healthcare

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

033-R-0348 Issued in GA

Legal business name

DIVINE HEALTHCARE

Practice address

903 Shaftoe St NW
Kennesaw, GA 30152-6999

Phone

(678) 612-1700

NPI assigned

Nov 11, 2011

Last updated

Nov 11, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Eghosa E Odobo, RNNPI 1346653508

Title

President

Phone

(678) 358-4681

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eghosa Odobo

  • Family Nurse Practitioner
  • North Las Vegas, NV
  • NPI 1346653508
  NPD (past) Authorized official

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

{
    "created_epoch": "1320969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320969600000",
    "number": "1255618716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 SHAFTOE ST NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301526999",
            "telephone_number": "678-612-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 SHAFTOE ST NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301526999",
            "telephone_number": "678-612-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-11",
        "last_updated": "2011-11-11",
        "status": "A",
        "authorized_official_last_name": "ODOBO",
        "authorized_official_first_name": "EGHOSA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-358-4681",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "033-R-0348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Dimmock, OTR/L
• Julie Dinh
• Discover Chiropractic Inc.
• Discover Integrated Health, LLC
• James Michael Ditolla, D.O.
• Divine Team Homecare LLC
• Antwan Tavarious Dixon, LPC
• Jameka Dixon, MA, BCBA
• Michael Wade Dixon, DPM
• Doan Global LLC (Joint Regeneration of Dalton)

• Home Health Agency in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2011; 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.