HERITAGE MEDICAL HOUSE CALL (NPI# 1063778983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063778983 |
| Entity Type | Organization |
| Organization Name | HERITAGE MEDICAL HOUSE CALL |
| Practice Address |
925 Main Street Suite 300-13 Stone Mountain GA 30083-3098 |
| Mailing Address |
925 Main St Suite 300-13 Stone Mountain GA 30083-3098 |
| Practice Telephone | 8884619765 |
| Practice Fax Number | 6783811684 |
| Mailing Telephone | 8884619765 |
| Mailing Fax Number | 6783811684 |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2012-10-31 |
| Authorized Official Name | MR. KEVIN ALEXANDER LANE SR. (OWNER/MEMBER) |
| Authorized Official Telephone | 8884619765 |
| Authorized Official Credential | PA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 12018049 | GA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003124376A | 05 |
| Street Address |
925 MAIN STREET SUITE 300-13 |
| City | STONE MOUNTAIN |
| State | GA |
| Zip Code | 30083-3098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558830919 | Patriot Healthcare of Georgia, LLC | Family Medicine | 833 Hairston Road, Stone Mountain, GA 30083 | 2018-11-15 |
| 1710403431 | Trans Med Ems,llc | Ambulance | 4683 Redan Rd, Stone Mountain, GA 30083 | 2017-08-15 |
| 1447770482 | Dispatched Angels Home Care | In Home Supportive Care | 619 El Prado Court, Stone Mountain, GA 30083 | 2017-06-21 |
| 1396191086 | Suzanne Carter | Chore Provider | 1036 Allgood Rd, Stone Mountain, GA 30083 | 2016-05-11 |
| 1437520087 | Meaza Dada | Pharmacist | 1043 Thornwoode Lane, Stone Mountain, GA 30083 | 2015-10-08 |
| 1427436500 | Raeanne Elizabeth Gialanella | Occupational Therapist | 5839 Memorial Drive, Stone Mountain, GA 30083 | 2015-05-11 |
| 1265829824 | Latore Williams | Licensed Practical Nurse | 5300 Ridge Forest Drive, Stone Mountain, GA 30083 | 2015-04-22 |
| 1144625922 | Granville Theodore Freeman IIi | Counselor | 5000 Brittany Drive, Stone Mountain, GA 30083 | 2014-10-23 |
| 1588974208 | Terri R Collins | Counselor | 1020 Strap Hinge Trail, Stone Mountain, GA 30083 | 2010-10-15 |
| 1104064815 | Vistas Medical Center,pc | Clinic/Center | 5329 Memorial Dr Ste A, Stone Mountain, GEORGIA 30083 | 2009-02-03 |
| Find all providers in zip 30083 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093332785 | Dedicated Care Partners of Georgia | Home Health | 965 Main St Ste B, Stone Mountain, GA 30083-2984 | 2020-06-29 |
| 1649896325 | Ayana Williams | Home Health | 1006 Sly Fox Ct, Stone Mountain, GA 30088-2948 | 2020-06-18 |
| 1578194080 | Cathy Bond | Home Health | 5306 Oshea Ln, Stone Mountain, GA 30088-1417 | 2020-02-03 |
| 1851948251 | Sistercare Inc | Home Health | 5471 Memorial Dr Ste J1, Stone Mountain, GA 30083-3241 | 2019-08-20 |
| 1962058933 | Morningstar Kompanion LLC | Home Health | 1900 Glenn Club Dr Apt 801, Stone Mountain, GA 30087-3470 | 2019-08-14 |
| 1962055640 | Philemon Healthcare Services LLC | Home Health | 925 Main St Ste 300-116, Stone Mountain, GA 30083-3098 | 2019-07-22 |
| 1396270666 | All Around Healthcare | Home Health | 624 Grande Vw, Stone Mountain, GA 30087-6060 | 2017-04-25 |
| 1730623166 | Right Choice Home Care | Home Health | 6871 Rockbridge Rd, Stone Mountain, GA 30087-4814 | 2016-12-03 |
| 1871916676 | Joy Hardy | Home Health | 633 Deer Lake Trl, Stone Mountain, GA 30087-5494 | 2014-01-29 |
| 1154769834 | Lady C Services LLC. | Home Health | 5152 Memorial Dr Unit 830627, Stone Mountain, GA 30083-0106 | 2013-06-04 |
| Find all providers in STONE MOUNTAIN | ||||
| City | STONE MOUNTAIN |
| Zip Code | 30083 |
Please comment or provide details below to improve the information on HERITAGE MEDICAL HOUSE CALL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.