CCR Home Health Care

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

CCR HOME HEALTH CARE

Practice address

4460 Cloverville Rd
Fruitport, MI 49415-9714

Phone

(231) 773-8496

NPI assigned

Mar 25, 2009

Last updated

Mar 25, 2009By 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. Kelly Sue Payne

Title

Ceo

Phone

(231) 773-8496

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1376785105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 CLOVERVILLE RD",
            "city": "FRUITPORT",
            "state": "MI",
            "postal_code": "494159714",
            "telephone_number": "231-773-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 CLOVERVILLE RD",
            "city": "FRUITPORT",
            "state": "MI",
            "postal_code": "494159714",
            "telephone_number": "231-773-8496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCR HOME HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-25",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "231-773-8496",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Bonnier
• Sophia Spiros Bouyoucos-Sayen, RD
• Marissa Brandenburg, LPC
• Chase Burton
• Sameen Bashir Butt, M.D.
• Jacob Charron, MD
• Chelsea Klipfel, D.D.S., P.L.L.C. (Fruitport Family Dentistry)
• Christopher Sortman DDS, P.C. (Community Shores Dental)
• Country-Side Counseling & Consultation Services, PC
• Delphia Croff, NURSE PRACTITIONER

• Nursing Care Agency in Fruitport, MI
• Providers in Fruitport, MI by specialty
• Nursing Care Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; 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.