Divinitycares, Incorporation

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

DIVINITYCARES, INCORPORATION

Practice address

1202 Common St
Lake Charles, LA 70601-5254

Phone

(337) 990-0122

Fax

(337) 990-0124

NPI assigned

Oct 26, 2005

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Ediwna Harmon Bushnell

Title

Ceo

Phone

(337) 990-0122

Specialties & licenses 1

Addresses

Other names 1

• hospice Former legal business name

Locations

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1841280104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 COMMON ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015254",
            "telephone_number": "337-990-0122",
            "fax_number": "337-990-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 COMMON ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015254",
            "telephone_number": "337-990-0122",
            "fax_number": "337-990-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINITYCARES, INCORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BUSHNELL",
        "authorized_official_first_name": "EDIWNA",
        "authorized_official_middle_name": "HARMON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-990-0122",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "hospice",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Disney & Associates, Inc
• Mary Janelle Disney, PHD
• Anissa M Disnuke, MSN, APRN, FNP-C
• Diversified Health Care-Lake Charles, LLC (Lake Charles Care Center)
• Divinity Cares Incorporation
• Mary E. Dix
• Michelle Dixson
• Hieu Trong DO, MD
• Rusty John Dodd
• Mark Lance Doiron, MD

• Exclusive Provider Organization in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Exclusive Provider Organization in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.