NPIMap

Organization Active NPI

Life Changes - Cap Services

  • Home Health Agency
  • Winston Salem, NC
National Provider Identifier
1003193889
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC4410 Issued in NC
Legal business name
LIFE CHANGES - CAP SERVICES
Practice address
1001 S Marshall St
Suite 1-75
Winston Salem, NC 27101-5852
Phone
(704) 537-0096
Fax
(704) 537-6080
NPI assigned
Nov 8, 2011
Organization subpart
Yes
Parent organization
LIFE CHANGES HOME CARE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Authorized official

Name
Mr. Cedric Moore
Title
Administrator
Phone
(704) 537-0096

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC4410 NC Primary

Addresses

Primary practice location

1001 S Marshall St
Suite 1-75
Winston Salem, NC 27101-5852

Mailing address

1001 E WT Harris Blvd
Suite P-192
Charlotte, NC 28213-4104
Phone (704) 537-0096

Other identifiers 1

IdentifierTypeStateIssuer
3418536MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Life Changes - Cap Services2 organizations share this tax ID, including this one
Part of
Life Changes - Cap Services

Other organizations with this tax ID 1

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

Locations

1001 E Wt Harris Blvd
Ste P192
Charlotte, NC 28213

1001 S Marshall St
Ste 175
Winston Salem, NC 27101
Phone (704) 537-0096

NPI Registry JSON

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320710400000",
    "number": "1003193889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E WT HARRIS BLVD",
            "address_2": "SUITE P-192",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282134104",
            "telephone_number": "704-537-0096",
            "fax_number": "704-537-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S MARSHALL ST",
            "address_2": "SUITE 1-75",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271015852",
            "telephone_number": "704-537-0096",
            "fax_number": "704-537-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHANGES - CAP SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFE CHANGES HOME CARE, INC",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CEDRIC",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-537-0096",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC4410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418536",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.