Organization Active NPI

Community 1St Homecare LLC

  • Home Health Agency
  • Ellenwood, GA
National Provider Identifier
1922721331
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
COMMUNITY 1ST HOMECARE LLC
Practice address
4015 Broadleaf Walk
Ellenwood, GA 30294-1995
Phone
(404) 246-3454
NPI assigned
Sep 21, 2022
Last updated
Sep 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Authorized official

Name
Russell Mosley
Title
Owner/Vice President
Phone
(404) 246-3454

Specialties & licenses 1

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

Addresses

Primary practice location

4015 Broadleaf Walk
Ellenwood, GA 30294-1995

Mailing address

4015 Broadleaf Walk
Ellenwood, GA 30294-1995
Phone (404) 246-3454

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1922721331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 BROADLEAF WALK",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302941995",
            "telephone_number": "404-246-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 BROADLEAF WALK",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302941995",
            "telephone_number": "404-246-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY 1ST HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "MOSLEY",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER/VICE PRESIDENT",
        "authorized_official_telephone_number": "404-246-3454"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenwood, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.