Organization Active NPI

Choice of Life, LLC

  • Home Health Agency
  • Philadelphia, PA
National Provider Identifier
1417498262
Registry record updated Apr 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
163WH0200X Issued in PA
Legal business name
CHOICE OF LIFE, LLC
Practice address
5837 E. Roosevelt Blvd
Philadelphia, PA 19149-3726
Phone
(215) 501-3129
NPI assigned
Mar 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2017

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

Authorized official

Name
Ms. Linda R. Bryant, PRACTICAL NURSE
Title
Executive Director
Phone
(215) 501-3129

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 163WH0200X PA Primary

Addresses

Primary practice location

5837 E. Roosevelt Blvd
Philadelphia, PA 19149-3726

Mailing address

5837 Roosevelt Blvd
Philadelphia, PA 19149-3726
Phone (215) 501-3129

Other identifiers 1

IdentifierTypeStateIssuer
163WH0200XMedicaidPA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492128000000",
    "number": "1417498262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5837 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191493726",
            "telephone_number": "215-501-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5837 E. ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191493726",
            "telephone_number": "215-501-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOICE OF LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-13",
        "last_updated": "2017-04-14",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-501-3129",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PRACTICAL NURSE"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "163WH0200X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163WH0200X",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.