Epiphany Healthcare of Hammond

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

EPIPHANY HEALTHCARE OF HAMMOND

Doing business as

Back 2 Health Walk-In Clinic
Epiphany Healthcare of Hammond

Practice address

11059 Phylliss LN
Hammond, LA 70401-1102

Phone

(985) 209-6571

NPI assigned

Jul 20, 2018

Last updated

Sep 24, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Moore

Title

Ceo, Executive Director

Phone

(985) 209-6571

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 2

• Back 2 Health Walk-In Clinic Doing business as
• Epiphany Healthcare of Hammond Doing business as

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537747200000",
    "number": "1417434606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11059 PHYLLISS LN",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704011102",
            "telephone_number": "985-209-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11059 PHYLLISS LN",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704011102",
            "telephone_number": "985-209-6571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "906 CM Fagan Drive Bldg A Ste 6A",
            "address_purpose": "LOCATION",
            "city": "Hammond",
            "state": "LA",
            "postal_code": "70403",
            "country_code": "US",
            "telephone_number": "985-956-7370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EPIPHANY HEALTHCARE OF HAMMOND",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-09-24",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CEO, EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "985-209-6571",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2279H0200X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "LA",
            "license": "2203783830",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2203783830",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back 2 Health Walk-In Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Epiphany Healthcare of Hammond",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Epiphany Healthcare of Hammond",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madison Leigh Engels, LCSW
• Enhanced Life Chiropractic LLC
• Heidi Enk, RN
• Katelyn D Ennis
• Josette Ephemere, M.ED., LPC
• Epiphany Healthcare of Hammond
• Epiphany Healthcare System, Inc
• Megan Eppes, PHARMD
• Jazmin Escalante, FNP
• Morgan Esneault

• Home Health Agency in Hammond, LA
• Providers in Hammond, LA by specialty
• Home Health Agency in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.