The Good Shepherd Home Care, LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

THE GOOD SHEPHERD HOME CARE, LLC

Practice address

11223 Cornell Park Dr
Suite 401
Blue Ash, OH 45242-1835

Phone

(513) 488-1938

Fax

(513) 488-1934

NPI assigned

Sep 28, 2010

Organization subpart

No

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

Authorized official

Name

Mr. John Michael Wallace

Title

Ceo/VP of Business Development

Phone

(513) 488-1938

Specialties & licenses 4

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300320000000",
    "number": "1750690582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11223 CORNELL PARK DR",
            "address_2": "SUITE 401",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452421835",
            "telephone_number": "513-488-1938",
            "fax_number": "513-488-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11223 CORNELL PARK DR",
            "address_2": "SUITE 401",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452421835",
            "telephone_number": "513-488-1938",
            "fax_number": "513-488-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GOOD SHEPHERD HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-28",
        "last_updated": "2011-03-17",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO/VP OF BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "513-488-1938",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "OH",
            "license": "3114427",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3114427",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; 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.