Remigius Idaewor

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

PHCP009529 Issued in GA

Practice address

110 Eagle Spring Dr
Suite C
Stockbridge, GA 30281-6488

Phone

(678) 480-5315

NPI assigned

Aug 2, 2016

Last updated

Aug 2, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Health Systems LLC

  dba Pacific Home Health Care

  • Home Health Agency
  • Stockbridge, GA
  • NPI 1568915809
  NPD (past) Authorized official
• Pacific Health System LLC

  • Home Health Aide
  • Tucson, AZ
  • NPI 1407736135
  Authorized official Same address or phone

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1801349204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 EAGLE SPRING DR",
            "address_2": "SUITE C",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816488",
            "telephone_number": "678-480-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 EAGLE SPRING DR",
            "address_2": "SUITE C",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816488",
            "telephone_number": "678-480-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDAEWOR",
        "first_name": "REMIGIUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "GA",
            "license": "PHCP009529",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "GA",
            "license": "PHCP009529",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "GA",
            "license": "PHCP009529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA DEPARTMENT OF COMMUNITY HEALTH",
            "identifier": "PHCP009529",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daisha Hyde
• Hyer Dynamic Health Discoveries (Hy-Dy Inc.)
• Hyped 4 Health LLC (Hyped 4 Health)
• I Day at a Time Counseling
• I.M. Wellness Center, LLC
• Idoc Virtual Neuro Critical Care LLC
• Latoya Janae' Ifill, DDS
• Uchechuwkwu Joy Agor Igwe, MD
• In Loving Arms 5 Star Service LLC (Summer Hill Residential Care)
• Independence Optical

• Community Health Registered Nurse in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Community Health Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.