EPIPHANY HEALTHCARE SYSTEM, INC (NPI# 1124202973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124202973 |
| Entity Type | Organization |
| Organization Name | EPIPHANY HEALTHCARE SYSTEM, INC |
| Other Organization Name | ACCESSIBLE HEALTH CARE OF SOUTH ATLANTA |
| Practice Address |
1015 Tyrone Rd Ste 110 Tyrone GA 30290-2407 |
| Mailing Address |
4405 Mall Blvd Suite 518 Union City GA 30291-2044 |
| Practice Telephone | 7703063416 |
| Practice Fax Number | 7703063417 |
| Mailing Telephone | 7703063416 |
| Mailing Fax Number | 7703063417 |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2018-08-20 |
| Authorized Official Name | MR. DICKSON OSANU (ADMINISTRATOR) |
| Authorized Official Telephone | 7703063416 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 251E00000X | Home Health | 060-R-0322 | GA | Agencies |
| Other Name | Type Code |
|---|---|
| Accessible Health Care of South Atlanta | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 906 Fagan Drive, Bldg A. Suite 6a, Hammond, LA 70403 | 9859567370 | 9859567371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730660176 | Epiphany Healthcare System, Inc | Psychiatry & Neurology | 906 C M Fagan Dr Bldg A, Suite 6a, Hammond, LA 70403 | 2018-08-23 |
| Street Address |
1015 TYRONE RD STE 110 |
| City | TYRONE |
| State | GA |
| Zip Code | 30290-2407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407215361 | Kaitlin Lackey | Occupational Therapist | 105 Glendalough Court, Suite H, Tyrone, GA 30290 | 2016-02-19 |
| 1114211745 | Johannes Daniel Smit | Pharmacist | 525 Valleywood Drive, Tyrone, GA 30290 | 2011-05-31 |
| 1760700199 | Georgia Integrative Medicine | Preventive Medicine | 120 Milbrook Village Drive, Suite E, Tyrone, GA 30290 | 2010-05-10 |
| 1427384783 | Exelle Home Care | Home Health | 105 Silverthorn Drive, Tyrone, GA 30290 | 2009-10-21 |
| 1386884138 | Genesys Ob/gyn, LLC | Clinic/Center | 245 Greencastle Road, Tyrone, GA 30290 | 2009-03-05 |
| 1689858805 | Immediate Care Centers of Georgia, LLC | Clinic/Center | 190 Greencastle Rd., Tyrone, GA 30290 | 2007-12-24 |
| 1437212834 | Dawn M Coffman | Physician Assistant | 190 Handley Rd., Tyrone, GA 30290 | 2006-12-18 |
| 1912971805 | Jason Rex Lee | Dentist | 195 Greencastle Rd, Tyrone, GA 30290 | 2006-02-15 |
| 1053898759 | Heather Renee Ellis | Physical Therapist | 62 Carriage Oaks Dr, Tyrone, GA 30290 | 2018-07-25 |
| 1134630858 | Marjorie Yvette Elibert | Advanced Practice Midwife | 190 Handley Rd Ste A, Tyrone, GA 30290 | 2017-10-20 |
| Find all providers in zip 30290 | ||||
| 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 |
|---|---|---|---|---|
| 1235613159 | Esther Angels Homecare and Assisted Living Services | Home Health | 100 Lloyd Ave Ste B, Tyrone, GA 30290-2157 | 2018-09-17 |
| 1871803957 | Phyzer Homehealth Services,inc | Home Health | 1133 Senoia Rd, Tyrone, GA 30290-1625 | 2010-10-07 |
| 1427384783 | Exelle Home Care | Home Health | 105 Silverthorn Drive, Tyrone, GA 30290 | 2009-10-21 |
| 1740274505 | Home Health Agency Central Pennsylvania, LLC | Home Health | 221 Hospital Dr Ste 2, Tyrone, PA 16686-1826 | 2005-09-08 |
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| 1588263917 | 963 Hz LLC | Home Health | 621 Arbor Cir, Tucker, GA 30084-3061 | 2020-10-17 |
| 1811595283 | Rotex Healthcare Services LLC | Home Health | 1847 Canoe Rdg Nw, Kennesaw, GA 30152-6222 | 2020-10-16 |
| 1306444120 | Circle of Life Caregiver Services | Home Health | 1803 Wynnton Rd, Columbus, GA 31906-2929 | 2020-10-14 |
| 1740888437 | Arose Home Care Services,llc | Home Health | 3374 Stone Path Way, Powder Springs, GA 30127-5329 | 2020-10-14 |
| Find all providers with the same taxonomy | ||||
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| 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.