Organization Active NPI

Med Group Home Health Care, LLC

  • Home Health Agency
  • Mequon, WI
National Provider Identifier
1508173139
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MED GROUP HOME HEALTH CARE, LLC
Practice address
11051 N Towne Square Rd
Mequon, WI 53092-5051
Phone
(414) 755-2009
Fax
(414) 755-1767
NPI assigned
Sep 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Authorized official

Name
Mrs. Dariko Mekvabishvili
Title
President
Phone
(414) 755-2009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

11051 N Towne Square Rd
Mequon, WI 53092-5051

Mailing address

11051 N Towne Square Rd
Mequon, WI 53092-5051
Phone (414) 755-2009

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450656000000",
    "number": "1508173139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11051 N TOWNE SQUARE RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925051",
            "telephone_number": "414-755-2009",
            "fax_number": "414-755-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11051 N TOWNE SQUARE RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925051",
            "telephone_number": "414-755-2009",
            "fax_number": "414-755-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED GROUP HOME HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-02",
        "last_updated": "2015-12-21",
        "status": "A",
        "authorized_official_last_name": "MEKVABISHVILI",
        "authorized_official_first_name": "DARIKO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-755-2009",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; 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.