Individual provider Active NPI

Calvin Odell Brown

  • Home Health Agency
  • Rock Hill, SC
National Provider Identifier
1669932521
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
201901216 Issued in SC
Practice address
1609 Tate Rd
Rock Hill, SC 29732-8588
Phone
(803) 630-6751
NPI assigned
Mar 25, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 201901216 SC Primary

Addresses

Primary practice location

1609 Tate Rd
Rock Hill, SC 29732-8588

Mailing address

1609 Tate Rd
Rock Hill, SC 29732-8588
Phone (803) 630-6751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
201901216SCMDHome Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1669932521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 TATE RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297328588",
            "telephone_number": "803-630-6751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 TATE RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297328588",
            "telephone_number": "803-630-6751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CALVIN",
        "middle_name": "ODELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "SC",
            "license": "201901216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.