NPIMap

Organization Active NPI

Genesis Home Health Services, Inc.- Pca

  • In Home Supportive Care Agency
  • Elko, NV
National Provider Identifier
1386159648
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
GENESIS HOME HEALTH SERVICES, INC.- PCA
Practice address
2620 Ruby Vista Dr
Elko, NV 89801-1638
Phone
(775) 753-7626
Fax
(775) 753-7626
NPI assigned
Dec 8, 2017
Last updated
Dec 8, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
GENESIS HOME HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Authorized official

Name
Querubin Iguban, MD
Title
Ceo
Phone
(775) 753-7626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

2620 Ruby Vista Dr
Elko, NV 89801-1638

Mailing address

2620 Ruby Vista Dr
Elko, NV 89801-1638
Phone (775) 753-7626

Other identifiers 1

IdentifierTypeStateIssuer
173342000194MedicaidNV

National Provider Directory

National Provider Directory
Tax ID family
Genesis Home Health Services Inc3 organizations share this tax ID, including this one
Part of
Genesis Home Health Services Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512691200000",
    "number": "1386159648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 RUBY VISTA DR",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898011638",
            "telephone_number": "775-753-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 RUBY VISTA DR",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898011638",
            "telephone_number": "775-753-7626",
            "fax_number": "775-753-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HOME HEALTH SERVICES, INC.- PCA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENESIS HOME HEALTH SERVICES, INC.",
        "enumeration_date": "2017-12-08",
        "last_updated": "2017-12-08",
        "status": "A",
        "authorized_official_last_name": "IGUBAN",
        "authorized_official_first_name": "QUERUBIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "775-753-7626",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173342000194",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elko, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2017; 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.