Organization Active NPI

First Corinthian Homecare, Inc.

  • In Home Supportive Care Agency
  • Marietta, GA
National Provider Identifier
1699058883
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
033-R-0815 Issued in GA
Legal business name
FIRST CORINTHIAN HOMECARE, INC.
Practice address
2759 Delk Rd SE
Suite 2550
Marietta, GA 30067-8847
Phone
(770) 627-5029
Fax
(770) 485-5361
NPI assigned
Sep 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2012

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

Authorized official

Name
Ted Ibegbulam
Title
Administrator
Phone
(770) 627-5029

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X 033-R-0815 GA
In Home Supportive Care Agency 253Z00000X 033-R-0815 GA Primary

Addresses

Primary practice location

2759 Delk Rd SE
Suite 2550
Marietta, GA 30067-8847

Mailing address

2759 Delk Rd SE
Suite 2550
Marietta, GA 30067-8847
Phone (770) 627-5029

Other identifiers 1

IdentifierTypeStateIssuer
003123352AMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
First Corinthian Homecare Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2759 Delk Rd SE
Ste 2550
Marietta, GA 30067
Phone (770) 627-5029

NPI Registry JSON

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336089600000",
    "number": "1699058883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2759 DELK RD SE",
            "address_2": "SUITE 2550",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678847",
            "telephone_number": "770-627-5029",
            "fax_number": "770-485-5361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2759 DELK RD SE",
            "address_2": "SUITE 2550",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678847",
            "telephone_number": "770-627-5029",
            "fax_number": "770-485-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CORINTHIAN HOMECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-23",
        "last_updated": "2012-05-04",
        "status": "A",
        "authorized_official_last_name": "IBEGBULAM",
        "authorized_official_first_name": "TED",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-627-5029"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "033-R-0815",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "033-R-0815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003123352A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; 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.