Provident Home Care, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PROVIDENT HOME CARE, INC.

Practice address

925 S Church St Ste B200
Murfreesboro, TN 37130-4993

Phone

(615) 962-7217

Fax

(615) 962-7298

NPI assigned

Sep 12, 2022

Last updated

Aug 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. David E Wilson, CPA

Title

Owner/Cfo

Phone

(615) 347-0900

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1962123513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 S ATLANTIC AVE APT 204",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329312374",
            "telephone_number": "615-347-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 S CHURCH ST STE B200",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371304993",
            "telephone_number": "615-962-7217",
            "fax_number": "615-962-7298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71 New Bushy Branch Rd",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "TN",
            "postal_code": "373555809",
            "country_code": "US",
            "telephone_number": "615-624-1836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROVIDENT HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-12",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/CFO",
        "authorized_official_telephone_number": "615-347-0900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.