NPIMap

Organization Active NPI

Supreme Community Health Connection Incorporated

  • In Home Supportive Care Agency
  • Peabody, MA
National Provider Identifier
1275918104
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
S49909797 Issued in MA
Legal business name
SUPREME COMMUNITY HEALTH CONNECTION INCORPORATED
Practice address
26 Shore Dr Apt B
Peabody, MA 01960-3099
Phone
(978) 201-8051
NPI assigned
Jul 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Authorized official

Name
Tabitha KanyuaNPI 1841675774
Title
President
Phone
(978) 201-8051

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X S49909797 MA Primary

Addresses

Primary practice location

26 Shore Dr Apt B
Peabody, MA 01960-3099

Mailing address

26 Shore Dr Apt B
Peabody, MA 01960-3099
Phone (978) 201-8051

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": "1437436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437436800000",
    "number": "1275918104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 SHORE DR APT B",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019603099",
            "telephone_number": "978-201-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 SHORE DR APT B",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019603099",
            "telephone_number": "978-201-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME COMMUNITY HEALTH CONNECTION INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-21",
        "last_updated": "2015-07-21",
        "status": "A",
        "authorized_official_last_name": "KANYUA",
        "authorized_official_first_name": "TABITHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-201-8051"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MA",
            "license": "S49909797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; 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.