Home Brokerage Case Management

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

HOME BROKERAGE CASE MANAGEMENT

Practice address

255 Julia CT
Fayetteville, GA 30214-7132

Phone

(770) 906-7421

NPI assigned

Mar 24, 2021

Last updated

Mar 24, 2021By 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

Charity A Ezeasore, RN

Title

Case Manager

Phone

(770) 906-7421

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1649857988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 JULIA CT",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147132",
            "telephone_number": "770-906-7421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 JULIA CT",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147132",
            "telephone_number": "770-906-7421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME BROKERAGE CASE MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "EZEASORE",
        "authorized_official_first_name": "CHARITY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CASE MANAGER",
        "authorized_official_telephone_number": "770-906-7421",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Fayetteville, GA
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• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.