Dahyojendayi L Fullwood

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

IHCP-1297 Issued in SC

Practice address

3236 Landmark Dr Ste 121
North Charleston, SC 29418-8490

Phone

(866) 491-1636

Fax

(843) 737-4896

NPI assigned

Sep 2, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aries Home Care LLC

  • In Home Supportive Care Agency
  • N Charleston, SC
  • NPI 1801721998
  NPD Authorized official

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1669086112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 RIVERS AVE",
            "address_2": "SUITE 370 PMB#155",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294065008",
            "telephone_number": "866-491-1636",
            "fax_number": "843-737-4896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3236 LANDMARK DR STE 121",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294188490",
            "telephone_number": "866-491-1636",
            "fax_number": "843-737-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLWOOD",
        "first_name": "DAHYOJENDAYI",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-02",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "SC",
            "license": "IHCP-1297",
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "SC",
            "license": "IHCP-1297",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "SC",
            "license": "IHCP-1297",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "SC",
            "license": "IHCP-1297",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "SC",
            "license": "IHCP-1297",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "SC",
            "license": "IHCP-1297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fresh Start Home Care LLC
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• Full Spectrum ABA of South Carolina LLC
• Dara Fuller, OTD
• Latrella Fulton
• Erik Furseth, DPT
• Trevor Gabel-Baird, DNP, FNP-C
• Shatanna Nicola Gaffney
• Stephen Anthony Gai

• In Home Supportive Care Agency in North Charleston, SC
• Providers in North Charleston, SC by specialty
• In Home Supportive Care Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; 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.