Active NPI
Kostic Group LLC
- Home Health Agency
- Marietta, GA
National Provider Identifier
1376804427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 033R1034
- Legal business name
- KOSTIC GROUP LLC
- Doing business as
- Kostic Healthcare
- Practice address
- 2985 Gordy Pkwy
Suite 212
Marietta, GA 30066-3078 - Phone
- (770) 672-6175
- Fax
- (770) 578-9126
- NPI assigned
- Jun 5, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Toyin T Adelaja
- Title
- President
- Phone
- (770) 672-6175
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 033R1034 | GA | Primary |
Addresses
Primary practice location
2985 Gordy Pkwy
Suite 212
Marietta, GA 30066-3078
Mailing address
2985 Gordy Pkwy
Suite 212
Marietta, GA 30066-3078
Phone (770) 672-6175
Other names 1
- Kostic Healthcare
National Provider Directory
National Provider DirectoryLocations
2985 Gordy Pkwy
Ste 203
Marietta, GA 30066
2985 Gordy Pkwy
Ste 212
Marietta, GA 30066
Phone (770) 672-6175
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338854400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1338854400000",
"number": "1376804427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2985 GORDY PKWY",
"address_2": "SUITE 212",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300663078",
"telephone_number": "770-672-6175",
"fax_number": "770-578-9126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2985 GORDY PKWY",
"address_2": "SUITE 212",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300663078",
"telephone_number": "770-672-6175",
"fax_number": "770-578-9126"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KOSTIC GROUP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-06-05",
"last_updated": "2012-06-05",
"status": "A",
"authorized_official_last_name": "ADELAJA",
"authorized_official_first_name": "TOYIN",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "770-672-6175",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "GA",
"license": "033R1034",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Kostic Healthcare",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.