Personal Care Home C&G

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

724086 Issued in PA

Legal business name

PERSONAL CARE HOME C&G

Practice address

6176 Newtown Ave
Philadelphia, PA 19111

Phone

(267) 235-7138

NPI assigned

Mar 8, 2017

Organization subpart

No

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

Authorized official

Name

Danielle Davis, M. A

Title

Mental Health Counselor

Phone

(267) 235-7138

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Darrell Keith Choates Sr., CARE GIVER

  • Mental Health Counselor
  • Glassboro, NJ
  • NPI 1649710096
  NPD
• Ramesh Parchuri, M.D,

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1437224300
  NPD (past)
• Samuel Ferguson Quartey, DPM

  • Podiatrist
  • Philadelphia, PA
  • NPI 1225005150
  NPD (past)

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1952841041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6176 NEWTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191115928",
            "telephone_number": "267-235-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6176 NEWTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19111",
            "telephone_number": "267-235-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL CARE HOME C&G",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-08",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "267-235-7138",
        "authorized_official_credential": "M. A"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "PA",
            "license": "724086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "724086",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashleigh Persico
• Yuri Persidsky, MD., PHD.
• Person Centered Homecare LLC
• Person-Centered Home & Community Services, Inc.
• Keyana Person
• Personal Care Home C&G Medical Clinic, PLLC
• Personal Care Home C&G Medical Clinic, PLLC
• Personal Care Home C&G, Inc
• Personal Evolution LLC
• Personal Injury Clinic PC

• Point of Service in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Point of Service in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.