Andre Washington

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

218782 Issued in SC

Practice address

20 Mystic CT
Dalzell, SC 29040-8382

Phone

(803) 236-6233

NPI assigned

Dec 2, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1497350888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MYSTIC CT",
            "city": "DALZELL",
            "state": "SC",
            "postal_code": "290408382",
            "telephone_number": "803-236-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MYSTIC CT",
            "city": "DALZELL",
            "state": "SC",
            "postal_code": "290408382",
            "telephone_number": "803-236-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "ANDRE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "SC",
            "license": "218782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "218782",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Healthylivingservices@yahoo.com",
            "affiliation": "N",
            "endpointDescription": "Company Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "20 Mystic Ct",
            "city": "Dalzell",
            "state": "SC",
            "country_code": "US",
            "postal_code": "290408382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cheryl Poole Arnold, RPH
• Laura Yvonne Smith, APRN, FNP-BC
• South Carolina Medical Transport LLC
• Rashona Lakayla Sweat
• Anita L Tobiere, MS, CCC-SLP
• Danielle Wathen
• Quavon Whitfield

• Home Health Aide in Dalzell, SC
• Providers in Dalzell, SC by specialty
• Home Health Aide in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.