Individual provider Active NPI

Mariam Bedoidze, ASSOCIATE DEGREE

  • In Home Supportive Care Agency
  • Wayne, PA
National Provider Identifier
1700723541
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
26173601 Issued in PA
Practice address
328 E Conestoga Rd
Wayne, PA 19087-2509
Phone
(215) 900-1681
NPI assigned
Apr 30, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 26173601 PA Primary

Addresses

Primary practice location

328 E Conestoga Rd
Wayne, PA 19087-2509

Mailing address

622 Norlyn CT
King of Prussia, PA 19406-3059
Phone (215) 900-1681

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
26173601PAMDIn Home Supportive Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1777507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1700723541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 NORLYN CT",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063059",
            "telephone_number": "215-900-1681",
            "fax_number": "215-876-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 E CONESTOGA RD",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190872509",
            "telephone_number": "215-900-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDOIDZE",
        "first_name": "MARIAM",
        "name_prefix": "Mrs.",
        "credential": "ASSOCIATE DEGREE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-30",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "PA",
            "license": "26173601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; 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.