Dis-Generation Group Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

379622 Issued in MN

Legal business name

DIS-GENERATION GROUP INC.

Practice address

6617 Quebec Ave N
Brooklyn Park, MN 55428-2234

Phone

(763) 232-1747

Fax

(763) 315-3020

NPI assigned

Dec 29, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Geoffrey Ifeanyi Iwuchukwu

Title

Ceo

Phone

(763) 443-7434

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1871038828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9032 PRESTWICK PKWY N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554433946",
            "telephone_number": "763-232-1747",
            "fax_number": "763-315-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6617 QUEBEC AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554282234",
            "telephone_number": "763-232-1747",
            "fax_number": "763-315-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIS-GENERATION GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-29",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "IWUCHUKWU",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "IFEANYI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-443-7434",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "379622",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MN",
            "license": "379622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.