PHENIX COMMUNITY CARE GROUP, LLC (NPI# 1215401617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215401617 |
| Entity Type | Organization |
| Organization Name | PHENIX COMMUNITY CARE GROUP, LLC |
| Practice Address |
6010 Yellowood Ct College Park GA 30349-6993 |
| Practice Telephone | 4048398994 |
| Mailing Telephone | 4048398994 |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2019-01-18 |
| Authorized Official Name | MR. GENE T KEITH JR. (CEO) |
| Authorized Official Telephone | 4048398994 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| Street Address |
6010 YELLOWOOD CT |
| City | COLLEGE PARK |
| State | GA |
| Zip Code | 30349-6993 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376185686 | Kmb Diagnostics | Durable Medical Equipment & Medical Supplies | 941 Flat Shoals Rd, Atlanta, GA 30349 | 2019-10-09 |
| 1114575859 | Justin Vassell | Registered Nurse | 1903 Phoenix Boulevard, Suite 200, College Park, GA 30349 | 2019-08-27 |
| 1841856663 | Kennyetta Danielle Watkins | Counselor | 1431 Riverwalk Ln, Apt. F, College Park, GA 30349 | 2019-05-16 |
| 1275002636 | Patriot Healthcare of Georgia, LLC | Family Medicine | 1587 Phoenix Boulevard, Suite 6, College Park, GA 30349 | 2018-11-15 |
| 1669971875 | Ee Consulting Solution | Case Management | 6320 Topaz Tral, Arlanta, GA 30349 | 2018-02-03 |
| 1629595640 | Shayla Bouie | Contractor | 5420 Riverdale Rd Apt D17, Atlanta, GA 30349 | 2017-08-30 |
| 1114475563 | Jasmine V Mccully | Social Worker | 5864 Summergien Lane, College Park, GA 30349 | 2016-09-14 |
| 1639537681 | Shelia Thornton | Counselor | 5856 Seabright Lane, Atlanta, GA 30349 | 2016-02-05 |
| 1346610177 | Joanne Resilard | Nurse Practitioner | 2931 Herron Ln Sw, Atlanta, GA 30349 | 2015-10-06 |
| 1063805091 | Southwest Atlanta Medical & Rehabilitation Clinic LLC | Family Medicine | 495 85 Circle, Suite 100, Atlanta, GA 30349 | 2015-03-16 |
| Find all providers in zip 30349 | ||||
| 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 |
|---|---|---|---|---|
| 1649818493 | Sucare Home Care Services | Home Health | 4920 Niagara Rd Ste 103, College Park, MD 20740-1110 | 2019-12-11 |
| 1649763038 | Community Health and Education Services LLC | Home Health | 7761 Diamondback Drive, College Park, MD 20742-2927 | 2018-06-11 |
| 1598265142 | Living Hope Home Care LLC | Home Health | 4854 Old National Hwy Ste 204, College Park, GA 30337-6245 | 2018-02-20 |
| 1932635943 | Advent Nursing Care Services Inc | Home Health | 9601 Baltimore Ave Ste A1, College Park, MD 20740-1355 | 2017-05-11 |
| 1154707529 | Sacred Care | Home Health | 5516 Glen Haven Dr, College Park, GA 30349-6728 | 2015-08-07 |
| 1336540061 | Community Support System LLC | Home Health | 4920 Niagara Rd Ste 402, College Park, MD 20740-1158 | 2014-09-12 |
| 1134568611 | Gods Appointed Time Private Homecare | Home Health | 2625 Charlestown Dr, College Park, GA 30337-3943 | 2013-06-18 |
| 1497018550 | Valerie Banks | Home Health | 3820 Clearwater Drive, College Park, GA 30349 | 2012-06-22 |
| 1437441896 | Ultimate Goal Home Care Agency Inc | Home Health | 4920 Niagara Rd Ste 318, College Park, MD 20740-1110 | 2011-05-04 |
| 1053641738 | In Helping Hands LLC | Home Health | 5401 Old National Hwy Apt 1506, College Park, GA 30349-3225 | 2010-01-02 |
| Find all providers in COLLEGE PARK | ||||
| City | COLLEGE PARK |
| Zip Code | 30349 |
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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.