Providence Companion Care of TN 1, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

I000000018767 Issued in TN

Legal business name

PROVIDENCE COMPANION CARE OF TN 1, LLC

Doing business as

Providence Companion Care

Practice address

600 N State of Franklin Rd
Suite 10
Johnson City, TN 37604-8226

Phone

(423) 220-1266

Fax

(866) 404-0950

NPI assigned

Aug 5, 2016

Last updated

Aug 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hunter L Simpson

Title

Managing Partner

Phone

(423) 220-1266

Specialties & licenses 1

Addresses

Other names 1

• Providence Companion Care Doing business as

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470355200000",
    "number": "1639623754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N STATE OF FRANKLIN RD",
            "address_2": "SUITE 10",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048226",
            "telephone_number": "423-220-1266",
            "fax_number": "866-404-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N STATE OF FRANKLIN RD",
            "address_2": "SUITE 10",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048226",
            "telephone_number": "423-220-1266",
            "fax_number": "866-404-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE COMPANION CARE OF TN 1, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-05",
        "last_updated": "2016-08-05",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "HUNTER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "423-220-1266"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "TN",
            "license": "I000000018767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Companion Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in Johnson City, TN
• Providers in Johnson City, TN by specialty
• In Home Supportive Care Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2016; 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.