NPIMap

Organization Active NPI

In Home Health, LLC

Doing business as ProMedica Hospice (Brunswick)

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Brunswick, GA
National Provider Identifier
1821713983
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
IN HOME HEALTH, LLC
Doing business as
ProMedica Hospice (Brunswick)
Practice address
664 Scranton Rd Ste 103
Brunswick, GA 31520-1946
Phone
(912) 261-8760
NPI assigned
Oct 11, 2022
Last updated
Oct 11, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
IN HOME HEALTH, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Authorized official

Name
Martin David Allen
Title
Director
Phone
(419) 252-5734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X NU Primary

Addresses

Primary practice location

664 Scranton Rd Ste 103
Brunswick, GA 31520-1946

Mailing address

333 N Summit St
Toledo, OH 43604-1531
Phone (567) 585-1191

Other identifiers 1

IdentifierTypeStateIssuer
858682596AMedicaidGA

Other names 1

  • ProMedica Hospice (Brunswick) Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Promedica Hospice Toledo24 organizations share this tax ID, including this one
Part of
Promedica Hospice Toledo

Other organizations with this tax ID 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665446400000",
    "number": "1821713983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531",
            "telephone_number": "567-585-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 SCRANTON RD STE 103",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315201946",
            "telephone_number": "912-261-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HOME HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IN HOME HEALTH, LLC",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "858682596A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Brunswick)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.