Supreme Home Care, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HHA3554 Issued in AZ

Legal business name

SUPREME HOME CARE, INC

Practice address

1204 E Baseline Rd Ste 204
Tempe, AZ 85283-1453

Phone

(602) 454-0155

Fax

(602) 454-0156

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Gary Davis

Title

President

Phone

(602) 454-0155

Specialties & licenses 1

Addresses

Other identifiers 1

Listed as

Supreme Home Care, Inc.CCN 037231

Ownership

Proprietary

Certified

Sep 2, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Physical therapy, Speech pathology, Occupational therapy

Locations

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1295951473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 E BASELINE RD STE 204",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831453",
            "telephone_number": "602-454-0155",
            "fax_number": "602-454-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 E BASELINE RD STE 204",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831453",
            "telephone_number": "602-454-0155",
            "fax_number": "602-454-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME HOME CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-454-0155",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "HHA3554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "927577",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cherron Sutten, NMD
• Adrian Erica Sutter, PA-C
• Judith Sutter, PH.D. CCC-SLP

• Home Health Agency in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Home Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.