NPIMap

Organization Active NPI

Ruby's Personal Home Care LLC.

  • Adult Care Home Facility
  • Conyers, GA
National Provider Identifier
1366721946
Registry record updated Aug 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
PCH005620 Issued in GA
Legal business name
RUBY'S PERSONAL HOME CARE LLC.
Practice address
2625 Fieldstone View LN SE
Conyers, GA 30013-2184
Phone
(770) 679-5482
Fax
(770) 679-0619
NPI assigned
Aug 12, 2011
Last updated
Aug 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2011

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

Authorized official

Name
Dr. Christine Lawes
Title
Administrator/Owner
Phone
(770) 679-5482

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X PCH005620 GA Primary

Addresses

Primary practice location

2625 Fieldstone View LN SE
Conyers, GA 30013-2184

Mailing address

2117 Fieldstone View CT SE
Conyers, GA 30013-6755
Phone (770) 679-5482

Other identifiers 1

IdentifierTypeStateIssuer
PCH005620OtherGAGEORGIA DEPARTMENT OF COMMUNITY HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251113000252 GA Part B Supplier - Clinic/Group Practice 0042757726 Receives reassigned benefits from 2 practitioners
Practice locations: Conyers, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1313107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313107200000",
    "number": "1366721946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 FIELDSTONE VIEW CT SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136755",
            "telephone_number": "770-679-5482",
            "fax_number": "770-679-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 FIELDSTONE VIEW LN SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132184",
            "telephone_number": "770-679-5482",
            "fax_number": "770-679-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUBY'S PERSONAL HOME CARE LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-12",
        "last_updated": "2011-08-12",
        "status": "A",
        "authorized_official_last_name": "LAWES",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "770-679-5482",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "GA",
            "license": "PCH005620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA DEPARTMENT OF COMMUNITY HEALTH",
            "identifier": "PCH005620",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.