KCS Medical Home Care Supplies Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

KCS MEDICAL HOME CARE SUPPLIES INC

Practice address

100 Etowah Trace
Fayetteville, GA 30214

Phone

(770) 716-7678

Fax

(770) 716-1814

NPI assigned

Jul 10, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Listra Gopaul

Title

Medical Director

Phone

(770) 716-7678

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346274230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ETOWAH TRACE",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-716-7678",
            "fax_number": "770-716-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ETOWAH TRACE",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-716-7678",
            "fax_number": "770-716-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KCS MEDICAL HOME CARE SUPPLIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOPAUL",
        "authorized_official_first_name": "LISTRA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-716-7678",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiran J Kanji, M.D.
• Mukti Bhatia Kanji, D.O.
• Rashaundria Kanu, CCC-SLP
• Paul Constantine Karagiannis, MD
• Komalpreet Kaur, PA-C
• Leah Keith, NP
• John A Keller, MD
• Pamela Kelley, NP-C
• Ashlei Henderson Kelly, PT, DPT
• Louise Kelly, LAPC

• Durable Medical Equipment & Medical Supplies in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.