NPIMap

Organization Active NPI

Care4All Community Care, Inc.

  • In Home Supportive Care Agency
  • Lawrenceville, GA
National Provider Identifier
1619539020
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
CARE4ALL COMMUNITY CARE, INC.
Practice address
1174 McKendree Church Rd Ste 100
Lawrenceville, GA 30043-6000
Phone
(678) 719-9677
Fax
(888) 620-3790
NPI assigned
Jul 5, 2019
Last updated
Nov 22, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Authorized official

Name
Mr. Smart GuobadiaNPI 1659930279
Title
Owner/Cfo
Phone
(615) 397-4996

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X NU
Nurse's Aide 376K00000X NU
Respite Care 385H00000X NU
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

1174 McKendree Church Rd Ste 100
Lawrenceville, GA 30043-6000

Mailing address

1174 McKendree Church Rd Ste 100
Lawrenceville, GA 30043-6000
Phone (678) 719-9677

Other identifiers 2

IdentifierTypeStateIssuer
003216332BMedicaidGA
003216332AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210322002568 GA Part B Supplier - Mass Immunization (Roster Biller Only) 2264849033 Practice locations: Lawrenceville, GA

National Provider Directory

National Provider Directory

Locations

1174 McKendree Church Rd
Ste 100
Lawrenceville, GA 30043
Phone (470) 338-1671

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574380800000",
    "number": "1619539020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 MCKENDREE CHURCH RD STE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436000",
            "telephone_number": "678-719-9677",
            "fax_number": "888-620-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 MCKENDREE CHURCH RD STE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436000",
            "telephone_number": "678-719-9677",
            "fax_number": "888-620-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE4ALL COMMUNITY CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-05",
        "last_updated": "2019-11-22",
        "status": "A",
        "authorized_official_last_name": "GUOBADIA",
        "authorized_official_first_name": "SMART",
        "authorized_official_title_or_position": "OWNER/CFO",
        "authorized_official_telephone_number": "615-397-4996",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003216332B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003216332A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.