Pedialife Home Health Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PEDIALIFE HOME HEALTH INC.

Practice address

5500 E Loop 820 S
Suite 207
Fort Worth, TX 76119-6569

Phone

(817) 563-5433

Fax

(817) 563-5435

NPI assigned

Nov 21, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Develle Marie Dedrick, MSN, RN

Title

President

Phone

(817) 296-5938

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340582400000",
    "number": "1811264708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 E LOOP 820 S",
            "address_2": "SUITE 207",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761196569",
            "telephone_number": "817-563-5433",
            "fax_number": "817-563-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 E LOOP 820 S",
            "address_2": "SUITE 207",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761196569",
            "telephone_number": "817-563-5433",
            "fax_number": "817-563-5435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIALIFE HOME HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-21",
        "last_updated": "2012-06-25",
        "status": "A",
        "authorized_official_last_name": "DEDRICK",
        "authorized_official_first_name": "DEVELLE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-296-5938",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSN, RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.