NPIMap

Organization Active NPI

Pocahontas County Home Care Aide Agency

  • Home Health Agency
  • Pocahontas, IA
National Provider Identifier
1669547428
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
POCAHONTAS COUNTY HOME CARE AIDE AGENCY
Practice address
21 3Rd Ave NE
Pocahontas, IA 50574-1614
Phone
(712) 335-4587
Fax
(712) 335-3929
NPI assigned
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

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

Authorized official

Name
Ms. Jill Sue Conlin, LBSW
Title
Agency Director
Phone
(712) 335-4587

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X IA Primary

Addresses

Primary practice location

21 3Rd Ave NE
Pocahontas, IA 50574-1614

Mailing address

21 3Rd Ave NE
Pocahontas, IA 50574-1614
Phone (712) 335-4587

Other identifiers 1

IdentifierTypeStateIssuer
0119438OtherIAELDERLY WAIVER

National Provider Directory

National Provider Directory
Tax ID family
County of Pocahontas3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1669547428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 3RD AVE NE",
            "city": "POCAHONTAS",
            "state": "IA",
            "postal_code": "505741614",
            "telephone_number": "712-335-4587",
            "fax_number": "712-335-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 3RD AVE NE",
            "city": "POCAHONTAS",
            "state": "IA",
            "postal_code": "505741614",
            "telephone_number": "712-335-4587",
            "fax_number": "712-335-3929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCAHONTAS COUNTY HOME CARE AIDE AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "CONLIN",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "AGENCY DIRECTOR",
        "authorized_official_telephone_number": "712-335-4587",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LBSW"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDERLY WAIVER",
            "identifier": "0119438",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocahontas, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.