NPIMap

Organization Active NPI

Gentiva

  • Case Management Agency
  • Hartford, CT
National Provider Identifier
1912367194
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
GENTIVA
Practice address
20 Church St
Suite 11
Hartford, CT 06103-1246
Phone
(860) 528-4038
NPI assigned
Mar 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Authorized official

Name
Lamisha S Corley, M.D.
Title
Clinical Supervisor
Phone
(860) 528-4037

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X CT Primary
Assisted Living Facility 310400000X 1417097593 CT

Addresses

Primary practice location

20 Church St
Suite 11
Hartford, CT 06103-1246

Mailing address

52 Deerwood LN
11
Waterbury, CT 06704-6110

National Provider Directory

National Provider Directory
Tax ID family
Gentiva Health Services Ipa Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1912367194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 DEERWOOD LN",
            "address_2": "11",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067046110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CHURCH ST",
            "address_2": "SUITE 11",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061031246",
            "telephone_number": "860-528-4038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENTIVA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-01",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "CORLEY",
        "authorized_official_first_name": "LAMISHA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "860-528-4037",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CT",
            "license": null,
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CT",
            "license": "1417097593",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.