NPIMap

Organization Active NPI

Pur-Pus Supported Living

  • Home Health Agency
  • Columbus, OH
National Provider Identifier
1346095395
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PUR-PUS SUPPORTED LIVING
Practice address
5150 E Main St
Columbus, OH 43213-2441
Phone
(614) 671-1868
NPI assigned
Apr 23, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Authorized official

Name
Tomika Gortdon
Title
Managing Member
Phone
(614) 946-5504

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Assisted Living Facility (Behavioral Disturbances) 3104A0630X

Addresses

Primary practice location

5150 E Main St
Columbus, OH 43213-2441

Mailing address

5150 E Main St Lowr Level
Columbus, OH 43213-2441
Phone (614) 671-1868

Other names 1

  • Pur-Pus LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pur Pus Supported Living2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1713830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1346095395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 E MAIN ST LOWR LEVEL",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432132441",
            "telephone_number": "614-671-1868",
            "fax_number": "614-604-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432132441",
            "telephone_number": "614-671-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUR-PUS SUPPORTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "GORTDON",
        "authorized_official_first_name": "TOMIKA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "614-946-5504"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pur-Pus LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.