NPIMap

Organization Active NPI

Carol's Home Afc

  • Respite Care
  • New Buffalo, MI
National Provider Identifier
1639581812
Registry record updated May 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
License
AF10093402 Issued in MI
Legal business name
CAROL'S HOME AFC
Practice address
13165 Wilton Ave
New Buffalo, MI 49117-9122
Phone
(269) 469-2000
NPI assigned
May 22, 2014
Last updated
May 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2014

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

Authorized official

Name
Mrs. Carol Ann Scissom, RN
Title
Owner
Phone
(269) 469-2825

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X AF10093402 MI Primary

Addresses

Primary practice location

13165 Wilton Ave
New Buffalo, MI 49117-9122

Mailing address

13165 Wilton Ave
New Buffalo, MI 49117-9122
Phone (269) 469-2000

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400716800000",
    "number": "1639581812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13165 WILTON AVE",
            "city": "NEW BUFFALO",
            "state": "MI",
            "postal_code": "491179122",
            "telephone_number": "269-469-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13165 WILTON AVE",
            "city": "NEW BUFFALO",
            "state": "MI",
            "postal_code": "491179122",
            "telephone_number": "269-469-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROL'S HOME AFC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-22",
        "last_updated": "2014-05-22",
        "status": "A",
        "authorized_official_last_name": "SCISSOM",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-469-2825",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "MI",
            "license": "AF10093402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Buffalo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; 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.