NPIMap

Organization Active NPI

Heavens Angel Homecare Agency

  • Customized Equipment (DME)
  • Travelers RST, SC
National Provider Identifier
1811531015
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
HEAVENS ANGEL HOMECARE AGENCY
Practice address
20 S Poinsett Hwy Ste I
Travelers RST, SC 29690-1857
Phone
(864) 787-7492
NPI assigned
Oct 30, 2019
Organization subpart
Yes
Parent organization
HEAVENS ANGEL HOMECARE AGENCYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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

Authorized official

Name
Tonya CheeksNPI 1881180297
Title
Owner
Phone
(864) 787-7492

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X

Addresses

Primary practice location

20 S Poinsett Hwy Ste I
Travelers RST, SC 29690-1857

Mailing address

109 Midwood Rd
Travelers RST, SC 29690-1865
Phone (864) 787-7492

Other identifiers 1

IdentifierTypeStateIssuer
EX1721MedicaidSC

Other names 1

  • Heavens Angel Homecare Agency Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Heavensangelhca@gmail.com

National Provider Directory

National Provider Directory
Tax ID family
Heavens Angel Homecare Agency2 organizations share this tax ID, including this one
Part of
Heavens Angel Homecare Agency

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

20 S Poinsett Hwy
Ste I
Travelers Rst, SC 29690
Phone (864) 787-7492

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572393600000",
    "number": "1811531015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 MIDWOOD RD",
            "city": "TRAVELERS RST",
            "state": "SC",
            "postal_code": "296901865",
            "telephone_number": "864-787-7492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S POINSETT HWY STE I",
            "city": "TRAVELERS RST",
            "state": "SC",
            "postal_code": "296901857",
            "telephone_number": "864-787-7492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENS ANGEL HOMECARE AGENCY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEAVENS ANGEL HOMECARE AGENCY",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A",
        "authorized_official_last_name": "CHEEKS",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-787-7492"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EX1721",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Heavensangelhca@gmail.com",
            "affiliation": "N",
            "address_1": "109 Midwood Rd",
            "city": "Travelers Rst",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296901865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Heavens Angel Homecare Agency",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Travelers RST, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.