Active NPI
Tabitha Paulk
- Home Health Aide
- Ambrose, GA
National Provider Identifier
1508407354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 1095 Gus Paulk Rd
Ambrose, GA 31512-3408 - Phone
- (912) 327-4967
- NPI assigned
- Oct 2, 2019
- Last updated
- Oct 2, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | |||
| Attendant Care Provider | 3747A0650X | |||
| Home Health Aide | 374U00000X | Primary | ||
| Nurse's Aide | 376K00000X |
Addresses
Primary practice location
1095 Gus Paulk Rd
Ambrose, GA 31512-3408
Mailing address
1095 Gus Paulk Rd
Ambrose, GA 31512-3408
Phone (912) 327-4967
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Ambrose |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Infinity Health Care Services | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Home Health Agency
- Ambrose, GA
- NPI 1164063640
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569974400000",
"number": "1508407354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1095 GUS PAULK RD",
"city": "AMBROSE",
"state": "GA",
"postal_code": "315123408",
"telephone_number": "912-327-4967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1095 GUS PAULK RD",
"city": "AMBROSE",
"state": "GA",
"postal_code": "315123408",
"telephone_number": "912-327-4967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULK",
"first_name": "TABITHA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-02",
"last_updated": "2019-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": true
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Ambrose",
"affiliation": "N",
"address_1": "1095 Gus Paulk Rd",
"city": "Ambrose",
"state": "GA",
"country_code": "US",
"postal_code": "315123408",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Ambrose, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.