Phase One Home Health LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PHASE ONE HOME HEALTH LLC

Practice address

109 Clayton CT
North Wales, PA 19454-1828

Phone

(215) 850-1928

NPI assigned

Sep 9, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Walter M Kinard Jr.

Title

Member

Phone

(215) 850-1928

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567987200000",
    "number": "1710536024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 COWPATH RD # 186",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194461563",
            "telephone_number": "215-850-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CLAYTON CT",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194541828",
            "telephone_number": "215-850-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHASE ONE HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-09",
        "last_updated": "2019-09-09",
        "status": "A",
        "authorized_official_last_name": "KINARD",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "215-850-1928",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1036532190001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "109 Clayton Ct",
            "city": "North Wales",
            "state": "PA",
            "country_code": "US",
            "postal_code": "194541828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• In Home Supportive Care Agency in North Wales, PA
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• In Home Supportive Care Agency in Pennsylvania

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