Independent Care Agency

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

INDEPENDENT CARE AGENCY

Doing business as

FirstLight Home Care North Dallas

Practice address

888 S Greenville Ave Ste 207
Richardson, TX 75081-5044

Phone

(815) 701-8389

NPI assigned

Aug 6, 2019

Organization subpart

No

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

Authorized official

Name

Stephanie G Johnson, RN

Title

Owner/Admistrator

Phone

(815) 701-8389

Specialties & licenses 1

Addresses

Other names 1

• FirstLight Home Care North Dallas Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565049600000",
    "number": "1861047904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 CANYON VALLEY DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750801934",
            "telephone_number": "815-701-8389",
            "fax_number": "224-206-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 S GREENVILLE AVE STE 207",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750815044",
            "telephone_number": "815-701-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT CARE AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/ADMISTRATOR",
        "authorized_official_telephone_number": "815-701-8389",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjohnson@firstlighthomecare.com",
            "affiliation": "N",
            "endpointDescription": "sjohnson@firstlighthomecare.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "888 S Greenville Ave Ste 207",
            "city": "Richardson",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750815044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "FirstLight Home Care North Dallas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.