Organization Active NPI

Gencare Health and Caregiver Services LLC

  • Family Nurse Practitioner
  • Douglasville, GA
National Provider Identifier
1265069405
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
GENCARE HEALTH AND CAREGIVER SERVICES LLC
Practice address
7336 Westwood LN
Douglasville, GA 30134-1092
Phone
(850) 345-3311
NPI assigned
Mar 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Authorized official

Name
Deaudrey Stokes Byrd, NPNPI 1851817886
Title
Administrator
Phone
(678) 523-9046

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Non-emergency Medical Transport (VAN) 343900000X
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

7336 Westwood LN
Douglasville, GA 30134-1092

Mailing address

7421 Douglas Blvd Ste N443
Douglasville, GA 30135-1564
Phone (678) 523-9046

National Provider Directory

National Provider Directory

Locations

7421 Douglas Blvd
Ste N443
Douglasville, GA 30135

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": "1585180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599091200000",
    "number": "1265069405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7421 DOUGLAS BLVD STE N443",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351564",
            "telephone_number": "678-523-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7336 WESTWOOD LN",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341092",
            "telephone_number": "850-345-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENCARE HEALTH AND CAREGIVER SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-26",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "DEAUDREY",
        "authorized_official_middle_name": "STOKES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "678-523-9046",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.