Carehalo Ohio LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

CAREHALO OHIO LLC

Practice address

2510 Dupont Circle Dr.
Suite 201
Fort Wayne, IN 46825

Phone

(770) 364-2184

NPI assigned

Jul 17, 2019

Organization subpart

No

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

Authorized official

Name

Tamika Goins

Title

President

Phone

(770) 364-2184

Specialties & licenses 1

Addresses

Other names 1

• CareHalo Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1962055152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 DALLAS HWY STE 200-243",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301276318",
            "telephone_number": "770-364-2184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 DUPONT CIRCLE DR.",
            "address_2": "SUITE 201",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46825",
            "telephone_number": "770-364-2184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5200 Dallas Hwy Ste 200-243",
            "address_purpose": "LOCATION",
            "city": "Powder Springs",
            "state": "GA",
            "postal_code": "301276318",
            "country_code": "US",
            "telephone_number": "770-364-2184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAREHALO OHIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "GOINS",
        "authorized_official_first_name": "TAMIKA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-364-2184"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "internal@carehalo.com",
            "affiliation": "N",
            "endpointDescription": "office email",
            "address_1": "5200 Dallas Hwy Ste 200-243",
            "city": "Powder Springs",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301276318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "CareHalo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.