Active NPI
Med Group Home Health Care, LLC
- Home Health Agency
- Mequon, WI
National Provider Identifier
1508173139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryNPI 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.