Jay E Deville, OWNER

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

057-R00-17 Issued in GA

Practice address

11 John Davenport Dr NW
Rome, GA 30165-2509

Phone

(706) 290-7701

Fax

(706) 290-7702

NPI assigned

Jan 26, 2022

Last updated

May 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northwest Ga Home Care/ Dba Right at Home

  dba Right At Home

  • Home Health Agency
  • Rome, GA
  • NPI 1770031478
  NPD Authorized official

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1407508948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 JOHN DAVENPORT DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652509",
            "telephone_number": "706-290-7701",
            "fax_number": "706-290-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 JOHN DAVENPORT DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652509",
            "telephone_number": "706-290-7701",
            "fax_number": "706-290-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVILLE",
        "first_name": "JAY",
        "middle_name": "E",
        "credential": "OWNER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-26",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "057-R-0017",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "057R0017",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "GA",
            "license": "057-R-0017",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "057-R00-17",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770031478",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mary Difonzo, MARY DIFONZO PA-C

• In Home Supportive Care Agency in Rome, GA
• Providers in Rome, GA by specialty
• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.