Your Independence Home Care Agency LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

YOUR INDEPENDENCE HOME CARE AGENCY LLC

Practice address

616 Alcott St
Philadelphia, PA 19120-1220

Phone

(267) 831-7032

NPI assigned

Feb 5, 2021

Organization subpart

No

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

Authorized official

Name

Shekia Johnson

Title

Owner

Phone

(267) 831-7032

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612483200000",
    "number": "1902498405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 ALCOTT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191201220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 ALCOTT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191201220",
            "telephone_number": "267-831-7032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR INDEPENDENCE HOME CARE AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHEKIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-831-7032"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH",
            "identifier": "52943601",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "yourindephca@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "shekiarj0520@gmail.com",
            "address_1": "616 Alcott St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191201220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.

Verify at the official NPI Registry.