NPIMap

Organization Active NPI

Medicrest Home Care

  • In Home Supportive Care Agency
  • McDonough, GA
National Provider Identifier
1376880492
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
075R0965 Issued in GA
Legal business name
MEDICREST HOME CARE
Practice address
15 Jonesboro St
Suite Rear
McDonough, GA 30253-3161
Phone
(404) 946-3313
NPI assigned
Jan 9, 2013
Last updated
Jan 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Authorized official

Name
Tova E Nieves
Title
Administrator
Phone
(404) 946-3313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 075R0965 GA Primary

Addresses

Primary practice location

15 Jonesboro St
Suite Rear
McDonough, GA 30253-3161

Mailing address

15 Jonesboro St
Suite Rear
McDonough, GA 30253-3161
Phone (404) 946-3313

National Provider Directory

National Provider Directory

Locations

15 Jonesboro St
Rear
McDonough, GA 30253
Phone (404) 946-3313

NPI Registry JSON

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357689600000",
    "number": "1376880492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 JONESBORO ST",
            "address_2": "SUITE REAR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533161",
            "telephone_number": "404-946-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 JONESBORO ST",
            "address_2": "SUITE REAR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533161",
            "telephone_number": "404-946-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICREST HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-09",
        "last_updated": "2013-01-09",
        "status": "A",
        "authorized_official_last_name": "NIEVES",
        "authorized_official_first_name": "TOVA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "404-946-3313"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "075R0965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; 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.