Phoenix Skilled Nursing Agency LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PHOENIX SKILLED NURSING AGENCY LLC

Practice address

530 Highland Station Dr Ste 3002
Suwanee, GA 30024-6576

Phone

(470) 266-1509

Fax

(470) 266-1540

NPI assigned

Oct 18, 2024

Organization subpart

No

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

Authorized official

Name

Emem UdoNPI 1801073465

Title

Owner

Phone

(404) 390-5587

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Emem Udo, MD

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1801073465
  NPD Authorized official

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1871314211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 HIGHLAND STATION DR STE 3002",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 HIGHLAND STATION DR STE 3002",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246576",
            "telephone_number": "470-266-1509",
            "fax_number": "470-266-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX SKILLED NURSING AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "UDO",
        "authorized_official_first_name": "EMEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-390-5587"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Phillips, RBT
• Morgan Alexandria Phillips, BA, RBT
• Tanja Phillips
• Briel Behavioral Philpot- Winkler
• Phoenix Oncology and Lymphedema Therapy, LLC
• Munamato Clarah Phometsi
• Physicians Eyecare of Georgia LLC
• Physiotherapy Associates Inc (Physio-Johns Creek)
• Jacqueline Ann Pickett
• Pickford Medical Services, LLC. (Pickford Medical Clinic)

• Home Health Agency in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; 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.