Redwood Private Care, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

REDWOOD PRIVATE CARE, LLC

Practice address

3715 Northside Parkway
Building 100 - Suite 500
Atlanta, GA 30327

Phone

(678) 517-4214

NPI assigned

Mar 24, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Owmy Bouloute, DPMNPI 1093013880

Title

Owner

Phone

(678) 517-4214

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Owmy Bouloute, DPM

  • Podiatrist
  • Woodbridge, VA
  • NPI 1093013880
  NPD Authorized official

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653264000000",
    "number": "1518544832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3904 N DRUID HILLS RD STE 104",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333105",
            "telephone_number": "678-517-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 NORTHSIDE PARKWAY",
            "address_2": "BUILDING 100 - SUITE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30327",
            "telephone_number": "678-517-4214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDWOOD PRIVATE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-24",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A",
        "authorized_official_last_name": "BOULOUTE",
        "authorized_official_first_name": "OWMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-517-4214",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destiny Redmond, LPC
• Elizabeth Holly Redmond, PHD, RDN
• Travis Redmond
• Raidel Redondo, PHARMD
• Tiffany Brenyce Redus, PHARMD
• William Mathew Redwood, MD
• Maite Reece, MA, PSYD
• Reed Physical Therapy LLC
• Eva Bonney Reed-Knight, PH.D.
• Alexis Reed

• Home Health Agency in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.