Organization Active NPI

Divine Community Healthcare Services, LLC

  • Home Health Agency
  • Reynoldsburg, OH
National Provider Identifier
1922258110
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
DIVINE COMMUNITY HEALTHCARE SERVICES, LLC
Practice address
7550 Slate Ridge Blvd
Reynoldsburg, OH 43068-3156
Phone
(614) 861-0861
Fax
(614) 861-8026
NPI assigned
Sep 24, 2008
Last updated
Sep 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Authorized official

Name
Ms. Angelique Maria Porter
Title
President
Phone
(614) 861-0861

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

7550 Slate Ridge Blvd
Reynoldsburg, OH 43068-3156

Mailing address

7550 Slate Ridge Blvd
Reynoldsburg, OH 43068-3156
Phone (614) 861-0861

Other identifiers 1

IdentifierTypeStateIssuer
2649227MedicaidOH

National Provider Directory

National Provider Directory

Locations

7550 Slate Ridge Blvd
Reynoldsburg, OH 43068
Phone (614) 861-0861

NPI Registry JSON

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1922258110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 SLATE RIDGE BLVD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430683156",
            "telephone_number": "614-861-0861",
            "fax_number": "614-861-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 SLATE RIDGE BLVD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430683156",
            "telephone_number": "614-861-0861",
            "fax_number": "614-861-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE COMMUNITY HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "ANGELIQUE",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-861-0861",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2649227",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reynoldsburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.