Dynamic Healthcare LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

DYNAMIC HEALTHCARE LLC

Practice address

408 7TH St Ste D-2
Eureka, CA 95501-6805

Phone

(707) 832-4277

Fax

(707) 832-4176

NPI assigned

Mar 23, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Larzie R Johnson, ASA/BA

Title

Founder/Ceo

Phone

(707) 832-4277

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dynamic healthcare LLC Other name

Locations

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332460800000",
    "number": "1629344601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 7TH ST STE D-2",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955016805",
            "telephone_number": "707-832-4277",
            "fax_number": "707-832-4176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 7TH ST STE D-2",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955016805",
            "telephone_number": "707-832-4277",
            "fax_number": "707-832-4176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-23",
        "last_updated": "2012-03-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LARZIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "FOUNDER/CEO",
        "authorized_official_telephone_number": "707-832-4277",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ASA/BA"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "251E00000X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic healthcare LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• In Home Supportive Care Agency in Eureka, CA
• Providers in Eureka, CA by specialty
• In Home Supportive Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; 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.