At Home Senior Care of America, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

AT HOME SENIOR CARE OF AMERICA, LLC

Practice address

5695 New Avedon Dr
Greensboro, NC 27455-8399

Phone

(336) 508-3642

NPI assigned

Apr 23, 2022

Organization subpart

No

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

Authorized official

Name

Peace Dzigdordi Dormon, HC PRACTITIONERNPI 1952890824

Title

Agency Director

Phone

(336) 508-3642

Specialties & licenses 1

Addresses

Other names 1

• At Home Senior Care of America, LLC Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peace Dzigbordi Dormon

  • Family Nurse Practitioner
  • Greensboro, NC
  • NPI 1952890824
  NPD Authorized official

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

{
    "created_epoch": "1650672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651795200000",
    "number": "1376287631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5695 NEW AVEDON DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274558399",
            "telephone_number": "336-508-3642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5695 NEW AVEDON DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274558399",
            "telephone_number": "336-508-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT HOME SENIOR CARE OF AMERICA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-23",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A",
        "authorized_official_last_name": "DORMON",
        "authorized_official_first_name": "PEACE",
        "authorized_official_middle_name": "DZIGDORDI",
        "authorized_official_title_or_position": "AGENCY DIRECTOR",
        "authorized_official_telephone_number": "336-508-3642",
        "authorized_official_credential": "HC PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "At Home Senior Care of America, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "At Home Senior Care of America, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Providers in Greensboro, NC by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.