Genesis

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

835552 Issued in TX

Legal business name

GENESIS

Practice address

700 Walnut Ridge Dr
3055
Irving, TX 75038-1000

Phone

(469) 835-6428

Fax

(972) 871-2740

NPI assigned

Dec 9, 2008

Organization subpart

No

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

Authorized official

Name

Carla Joanne Hannah

Title

Provider

Phone

(469) 835-6428

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228780800000",
    "number": "1700021441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 WALNUT RIDGE DR",
            "address_2": "3055",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750381000",
            "telephone_number": "469-835-6428",
            "fax_number": "972-871-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WALNUT RIDGE DR",
            "address_2": "3055",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750381000",
            "telephone_number": "469-835-6428",
            "fax_number": "972-871-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-09",
        "last_updated": "2008-12-09",
        "status": "A",
        "authorized_official_last_name": "HANNAH",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "JOANNE",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "469-835-6428"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": "835552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Irving, TX
• Providers in Irving, TX by specialty
• Case Manager/Care Coordinator in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; 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.