Divine Intervention Home Care

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

DIVINE INTERVENTION HOME CARE

Practice address

2155 Wow Rd
Randleman, NC 27317-7951

Phone

(336) 267-4517

NPI assigned

Jan 28, 2020

Last updated

Oct 10, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tralvis Shaw

Title

Ceo

Phone

(336) 267-4517

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1023649209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 WOW RD",
            "city": "RANDLEMAN",
            "state": "NC",
            "postal_code": "273177951",
            "telephone_number": "336-653-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 WOW RD",
            "city": "RANDLEMAN",
            "state": "NC",
            "postal_code": "273177951",
            "telephone_number": "336-267-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE INTERVENTION HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-28",
        "last_updated": "2022-10-10",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "TRALVIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-267-4517"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maci Olivia Burns Coward
• Heather Craven, PHARMD
• Janet Renee Crotty, NCLPC, NBCC
• Lindsey Jeanette Danielle Davis, PHARMD
• Deacon Med PA (Optimus Medical Center at Randleman)
• Dr. David Parsons D.D.S PA
• Madeline Elizabeth Duvall, M.A. CCC-SLP
• Katie Elkins
• Barry A. England, LPC
• Eyecarecenter OD PA (EyeCare Centers)

• Home Health Agency in Randleman, NC
• Providers in Randleman, NC by specialty
• Home Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.