Organization Active NPI

Kostic Group LLC

  • Home Health Agency
  • Marietta, GA
National Provider Identifier
1376804427
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
033R1034 Issued in GA
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

Updated by the provider on Jun 5, 2012

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)CodeLicenseStatePrimary
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 Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.