NPIMap

Organization Active NPI

Addus Healthcare (South Carolina), Inc.

Doing business as Addus HomeCare

  • In Home Supportive Care Agency
  • Smyrna, GA
National Provider Identifier
1336494798
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
044-R-1056 Issued in GA
Legal business name
ADDUS HEALTHCARE (SOUTH CAROLINA), INC.
Doing business as
Addus HomeCare
Practice address
3300 Highlands Pkwy SE
Suite 140
Smyrna, GA 30082-5131
Phone
(678) 287-7398
Fax
(855) 807-5843
NPI assigned
Jul 20, 2012
Last updated
Jun 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Authorized official

Name
Ms. Diane Kumarich, RN, MS, MBA
Title
National Contracts
Phone
(630) 296-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 044-R-1056 GA Primary

Addresses

Primary practice location

3300 Highlands Pkwy SE
Suite 140
Smyrna, GA 30082-5131

Mailing address

2300 Warrenville Rd
Suite 100
Downers Grove, IL 60515-1765
Phone (630) 296-3400

Other identifiers 2

IdentifierTypeStateIssuer
000972419MedicaidGA
044-R-1056OtherGALICENSE NUMBER

Other names 1

  • Addus HomeCare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Addus Healthcare South Carolina Inc28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

3300 Highlands Pkwy SE
Ste 140
Smyrna, GA 30082
Phone (678) 287-7398

NPI Registry JSON

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434499200000",
    "number": "1336494798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WARRENVILLE RD",
            "address_2": "SUITE 100",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151765",
            "telephone_number": "630-296-3400",
            "fax_number": "630-487-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 HIGHLANDS PKWY SE",
            "address_2": "SUITE 140",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300825131",
            "telephone_number": "678-287-7398",
            "fax_number": "855-807-5843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDUS HEALTHCARE (SOUTH CAROLINA), INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-20",
        "last_updated": "2015-06-17",
        "status": "A",
        "authorized_official_last_name": "KUMARICH",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "NATIONAL CONTRACTS",
        "authorized_official_telephone_number": "630-296-3400",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, MS, MBA"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "044-R-1056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000972419",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "044-R-1056",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Addus HomeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smyrna, GA

Sources for this page

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