Athome Therapy Solutions - South LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ATHOME THERAPY SOLUTIONS - SOUTH LLC

Practice address

222 Cambridge CT
Clifton, NJ 07014-1376

Phone

(347) 449-1639

NPI assigned

Jan 25, 2023

Organization subpart

No

Name

MC Gucken De Leon, PTNPI 1376724708

Title

Owner

Phone

(347) 449-1639

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• MC Gucken De Leon, PT

  • Physical Therapist
  • Clifton, NJ
  • NPI 1376724708

  NJ

  Medicare reassignment Authorized official

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 31, 2023.

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1871209577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 CAMBRIDGE CT",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070141376",
            "telephone_number": "347-449-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 CAMBRIDGE CT",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070141376",
            "telephone_number": "347-449-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHOME THERAPY SOLUTIONS - SOUTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "DE LEON",
        "authorized_official_first_name": "MC GUCKEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-449-1639",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.