Diamond One Healthcare

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

113004427 Issued in TN

Legal business name

DIAMOND ONE HEALTHCARE

Practice address

3514 Clearbrook St
Memphis, TN 38118-5547

Phone

(901) 362-6015

Fax

(901) 405-5106

NPI assigned

Oct 29, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Charles Edward Reynolds Jr., ULITMATE MEDICAL ACANPI 1346679990

Title

Ceo

Phone

(901) 362-6015

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• home healthcare Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Edward Reynolds Jr.

  • Home Health Agency
  • Memphis, TN
  • NPI 1346679990
  NPD (past) Authorized official

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1801224910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3514 CLEARBROOK ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381185547",
            "telephone_number": "901-362-6015",
            "fax_number": "901-405-5106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3514 CLEARBROOK ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381185547",
            "telephone_number": "901-362-6015",
            "fax_number": "901-405-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND ONE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "901-362-6015",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "ULITMATE MEDICAL ACA"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "TN",
            "license": "113004427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113004427",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "home healthcare",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Dialysis Newco LLC
• Dialysis Newco, Inc.
• Dialyze Direct TN, LLC
• Diamond Care ABA TN LLC
• Diamond Home Healthcare
• Constance Diamond
• Lynda Susan Diangelo, P.T.
• Jesus Hernando Diaz Acevedo, MD, MPH
• Alicia Marie Diaz-Thomas, MD
• Claro F Diaz, MD

• Exclusive Provider Organization in Memphis, TN
• Providers in Memphis, TN by specialty
• Exclusive Provider Organization in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.