Camelot House Incorporated

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

8897302 Issued in GA

Legal business name

CAMELOT HOUSE INCORPORATED

Practice address

3645 Marketplace Blvd
Suite 201
East Point, GA 30344-5747

Phone

(404) 796-1626

NPI assigned

Dec 6, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Paschal Ike, M.D.

Title

Ceo

Phone

(404) 796-1626

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354752000000",
    "number": "1295070852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 MARKETPLACE BLVD",
            "address_2": "SUITE 201",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303445747",
            "telephone_number": "404-796-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 MARKETPLACE BLVD",
            "address_2": "SUITE 201",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303445747",
            "telephone_number": "404-796-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT HOUSE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-06",
        "last_updated": "2012-12-06",
        "status": "A",
        "authorized_official_last_name": "IKE",
        "authorized_official_first_name": "PASCHAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-796-1626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "8897302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayanna V Buckner, MD
• Claire Kendall Bush, M.D.
• Cassandra Bussey, SPECIALIST
• Rhonda Charlette Bussey, LMSW
• Kevin K Calhoun
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• In Home Supportive Care Agency in East Point, GA
• Providers in East Point, GA by specialty
• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.