NPIMap

Organization Active NPI

Phenomenally Yours Healthcare LLC

  • Home Health Agency
  • Cleveland HTS, OH
National Provider Identifier
1518697184
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PHENOMENALLY YOURS HEALTHCARE LLC
Practice address
964 Brunswick Rd
Cleveland HTS, OH 44112-2315
Phone
(216) 551-6494
NPI assigned
Jun 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Authorized official

Name
Theodoria Smith
Title
Ceo
Phone
(216) 551-6494

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Private Vehicle 347C00000X
Adult CompanionGroup: 193200000X MULTI-SPECIALTY GROUP 372600000X
HomemakerGroup: 193200000X MULTI-SPECIALTY GROUP 376J00000X

Addresses

Primary practice location

964 Brunswick Rd
Cleveland HTS, OH 44112-2315

Mailing address

964 Brunswick Rd
Cleveland HTS, OH 44112-2315
Phone (216) 551-6494

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL desktop Direct
CONNECT URL desktop Direct

National Provider Directory

National Provider Directory
Tax ID family
Phenomenally Yours Healthcare LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655251200000",
    "number": "1518697184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "964 BRUNSWICK RD",
            "city": "CLEVELAND HTS",
            "state": "OH",
            "postal_code": "441122315",
            "telephone_number": "216-551-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "964 BRUNSWICK RD",
            "city": "CLEVELAND HTS",
            "state": "OH",
            "postal_code": "441122315",
            "telephone_number": "216-551-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHENOMENALLY YOURS HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "THEODORIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "216-551-6494"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "desktop",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "964 Brunswick Rd",
            "city": "Cleveland Hts",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441122315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "desktop",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "964 Brunswick Rd",
            "city": "Cleveland Hts",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441122315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cleveland HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.