NPIMap

Organization Active NPI

Davore Homecare LLC

  • In Home Supportive Care Agency
  • Stockbridge, GA
National Provider Identifier
1295491918
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
DAVORE HOMECARE LLC
Practice address
1129 Hospital Dr Ste 6F
Stockbridge, GA 30281-6393
Phone
(678) 835-3334
NPI assigned
Nov 17, 2021
Last updated
Nov 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Authorized official

Name
Olusola AderibigbeNPI 1720672777
Title
Partner
Phone
(718) 200-4219

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

1129 Hospital Dr Ste 6F
Stockbridge, GA 30281-6393

Mailing address

1129 Hospital Dr Ste 6F
Stockbridge, GA 30281-6393
Phone (678) 835-3334

Other identifiers 1

IdentifierTypeStateIssuer
PHCP011304OtherGAGEORGIA DEPARTMENT OF COMMUNITY HEALTH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stockbridgeinfo@synergyhomecare.com Direct

National Provider Directory

National Provider Directory

Locations

1129 Hospital Dr
Ste 6F
Stockbridge, GA 30281
Phone (678) 835-3334

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1295491918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 HOSPITAL DR STE 6F",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816393",
            "telephone_number": "678-835-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 HOSPITAL DR STE 6F",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816393",
            "telephone_number": "678-835-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVORE HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "ADERIBIGBE",
        "authorized_official_first_name": "OLUSOLA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "718-200-4219"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA DEPARTMENT OF COMMUNITY HEALTH",
            "identifier": "PHCP011304",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stockbridgeinfo@synergyhomecare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1129 Hospital Dr Ste 6F",
            "city": "Stockbridge",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302816393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.