Shannon Private Home Care, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SHANNON PRIVATE HOME CARE, INC.

Practice address

7080 Green Valley LN
Riverdale, GA 30274-3206

Phone

(678) 479-2027

NPI assigned

Sep 25, 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

Darrius E, Shannon

Title

Administrator

Phone

(678) 479-2027

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376643692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 961346",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302966904",
            "telephone_number": "678-479-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7080 GREEN VALLEY LN",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302743206",
            "telephone_number": "678-479-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON PRIVATE HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "DARRIUS",
        "authorized_official_middle_name": "E,",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "678-479-2027"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Riverdale, GA
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• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.