Credo Healthcare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CREDO HEALTHCARE LLC

Practice address

921 Smothermon Farm Rd
Little Elm, TX 75068-1010

Phone

(469) 345-4370

NPI assigned

Jul 11, 2022

Organization subpart

No

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

Authorized official

Name

Emmanuel Eben

Title

Administrator

Phone

(469) 345-4370

Specialties & licenses 1

Addresses

Other names 1

• CREDO HEALTHCARE LLC Former legal business name

Electronic endpoints 1

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1851025308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 SMOTHERMON FARM RD",
            "city": "LITTLE ELM",
            "state": "TX",
            "postal_code": "750681010",
            "telephone_number": "469-345-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 SMOTHERMON FARM RD",
            "city": "LITTLE ELM",
            "state": "TX",
            "postal_code": "750681010",
            "telephone_number": "469-345-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREDO HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "EBEN",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "469-345-4370"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EMAIL",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12801 N Central Expy Ste 750",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752431876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "CREDO HEALTHCARE LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "CREDO HEALTHCARE LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Home Health Agency in Little Elm, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.