NPIMap

Organization Active NPI

Trisouth Cap Services

  • Home Health Agency
  • Charlotte, NC
National Provider Identifier
1003040965
Registry record updated May 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC3525 Issued in NC
Legal business name
TRISOUTH CAP SERVICES
Practice address
756 Tyvola Rd
Suite 143
Charlotte, NC 28217-3588
Phone
(704) 525-2505
Fax
(704) 525-2506
NPI assigned
May 7, 2009
Organization subpart
Yes
Parent organization
TRISOUTH HEALTH SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 7, 2009

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

Authorized official

Name
Veronica Southerland, RN, BSW
Title
Administrator
Phone
(704) 493-3422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC3525 NC Primary

Addresses

Primary practice location

756 Tyvola Rd
Suite 143
Charlotte, NC 28217-3588

Mailing address

PO Box 242036
Charlotte, NC 28224-2036
Phone (704) 525-2505

Other identifiers 1

IdentifierTypeStateIssuer
3418482MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Trisouth Health Services Inc7 organizations share this tax ID, including this one
Part of
Trisouth Health Services Inc

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241654400000",
    "number": "1003040965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 242036",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282242036",
            "telephone_number": "704-525-2505",
            "fax_number": "704-525-2506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "756 TYVOLA RD",
            "address_2": "SUITE 143",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173588",
            "telephone_number": "704-525-2505",
            "fax_number": "704-525-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISOUTH CAP SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRISOUTH HEALTH SERVICES, INC",
        "enumeration_date": "2009-05-07",
        "last_updated": "2009-05-07",
        "status": "A",
        "authorized_official_last_name": "SOUTHERLAND",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-493-3422",
        "authorized_official_credential": "RN, BSW"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC3525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418482",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; 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.