Agape Chronic Care, LLC

Primary specialty

Chronic Care Clinical Nurse SpecialistTaxonomy code 364SC2300X

License

176831 Issued in GA

Legal business name

AGAPE CHRONIC CARE, LLC

Practice address

105 Weatherstone Dr Ste 620
Woodstock, GA 30188-7002

Phone

(770) 688-1090

Fax

(770) 225-2452

NPI assigned

Sep 27, 2016

Organization subpart

No

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

Authorized official

Name

Edwin J Cox III

Title

President/Owner

Phone

(770) 355-2066

Specialties & licenses 1

Addresses

Other names 1

• Agape PalCare, LLC Former legal business name

Locations

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

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1982153359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WEATHERSTONE DR STE 620",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301887002",
            "telephone_number": "770-688-1090",
            "fax_number": "770-225-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WEATHERSTONE DR STE 620",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301887002",
            "telephone_number": "770-688-1090",
            "fax_number": "770-225-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE CHRONIC CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-27",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "770-355-2066",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "364SC2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Chronic Care",
            "state": "GA",
            "license": "176831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agape PalCare, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• All providers in Woodstock, GA
• Chronic Care Clinical Nurse Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.