NPIMap

Organization Active NPI

Antioch Health Care Corp

  • Preferred Provider Organization
  • Antioch, TN
National Provider Identifier
1427418862
Registry record updated Feb 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
645163 Issued in TN
Legal business name
ANTIOCH HEALTH CARE CORP
Practice address
522 Bell Rd
Unit C
Antioch, TN 37013-2002
Phone
(615) 788-1047
NPI assigned
Feb 27, 2016
Last updated
Feb 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2016

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

Authorized official

Name
Mrs. Mabel Keyenasoa Ekundayo, RN
Title
Director
Phone
(615) 887-0309

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 645163 TN Primary

Addresses

Primary practice location

522 Bell Rd
Unit C
Antioch, TN 37013-2002

Mailing address

522 Bell Rd
Unit C
Antioch, TN 37013-2002
Phone (615) 788-1047

National Provider Directory

National Provider Directory

Locations

522 Bell Rd
Unit C
Antioch, TN 37013
Phone (615) 788-1047

NPI Registry JSON

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

{
    "created_epoch": "1456531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456531200000",
    "number": "1427418862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 BELL RD",
            "address_2": "UNIT C",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370132002",
            "telephone_number": "615-788-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 BELL RD",
            "address_2": "UNIT C",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370132002",
            "telephone_number": "615-788-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTIOCH HEALTH CARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-27",
        "last_updated": "2016-02-27",
        "status": "A",
        "authorized_official_last_name": "EKUNDAYO",
        "authorized_official_first_name": "MABEL",
        "authorized_official_middle_name": "KEYENASOA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-887-0309",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "TN",
            "license": "645163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.

Verify at the official NPI Registry.