Active NPI
Coosha'E Cares
- In Home Supportive Care Agency
- Philadelphia, PA
National Provider Identifier
1891376836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Legal business name
- COOSHA'E CARES
- Practice address
- 501 S 63Rd St Ste 1
Philadelphia, PA 19143-1018 - Phone
- (267) 507-0545
- NPI assigned
- Apr 20, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Shantae Coppock
- Title
- Owner/ Founder
- Phone
- (267) 241-1161
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| In Home Supportive Care Agency | 253Z00000X | Primary |
Addresses
Primary practice location
501 S 63Rd St Ste 1
Philadelphia, PA 19143-1018
Mailing address
501 S 63Rd St Ste 1
Philadelphia, PA 19143-1018
Phone (267) 507-0545
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618876800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1632873600000",
"number": "1891376836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 S 63RD ST STE 1",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191431018",
"telephone_number": "267-507-0545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S 63RD ST STE 1",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191431018",
"telephone_number": "267-507-0545"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COOSHA'E CARES",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-20",
"last_updated": "2021-09-29",
"certification_date": "2021-09-29",
"status": "A",
"authorized_official_last_name": "COPPOCK",
"authorized_official_first_name": "SHANTAE",
"authorized_official_title_or_position": "OWNER/ FOUNDER",
"authorized_official_telephone_number": "267-241-1161",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.