Active NPI
Gloria Minta
- Home Health Agency
- Lithonia, GA
National Provider Identifier
1417316779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 044-R-1382
- Practice address
- 1046 Palmer Rd
Lithonia, GA 30058-9085 - Phone
- (404) 454-9388
- NPI assigned
- Feb 15, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 044-R-1382 | GA | Primary |
Addresses
Primary practice location
1046 Palmer Rd
Lithonia, GA 30058-9085
Mailing address
1046 Palmer Rd
Lithonia, GA 30058-9085
Phone (404) 454-9388
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 044-R-1382 | GA | MD | Home Health Agency |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supreme Quality Home Care LLC | Home Health | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Health Agency
- Lithonia, GA
- NPI 1962951038
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455494400000",
"number": "1417316779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1046 PALMER RD",
"city": "LITHONIA",
"state": "GA",
"postal_code": "300589085",
"telephone_number": "404-454-9388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1046 PALMER RD",
"city": "LITHONIA",
"state": "GA",
"postal_code": "300589085",
"telephone_number": "404-454-9388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINTA",
"first_name": "GLORIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-15",
"last_updated": "2016-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "GA",
"license": "044-R-1382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lithonia, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.