Active NPI
Fatima Dennis
- In Home Supportive Care Agency
- Philadelphia, PA
National Provider Identifier
1699327288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 45993601
- Practice address
- 6548 N 17TH St
Philadelphia, PA 19126-3514 - Phone
- (814) 230-0026
- NPI assigned
- Jul 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 45993601 | PA | Primary |
Addresses
Primary practice location
6548 N 17TH St
Philadelphia, PA 19126-3514
Mailing address
6548 N 17TH St
Philadelphia, PA 19126-3514
Phone (215) 868-1261
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103798851 | Medicaid | PA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 45993601 | PA | MD | In Home Supportive Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1699327288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6548 N 17TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191263514",
"telephone_number": "215-868-1261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6548 N 17TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191263514",
"telephone_number": "814-230-0026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNIS",
"first_name": "FATIMA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-12",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "PA",
"license": "45993601",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103798851",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.