Individual provider Active NPI

Sylvie A Fandohan

  • Home Health Agency
  • Mooresville, NC
National Provider Identifier
1063246882
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC7552 Issued in NC
Practice address
131 Plantation Ridge Dr Ste 305
Mooresville, NC 28117-9543
Phone
(828) 540-0112
NPI assigned
Aug 26, 2024
Last updated
Aug 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X HC7552 NC
Respite Care 385H00000X HC7552 NC
Home Health Agency 251E00000X HC7552 NC Primary

Addresses

Primary practice location

131 Plantation Ridge Dr Ste 305
Mooresville, NC 28117-9543

Mailing address

131 Plantation Ridge Dr Ste 305
Mooresville, NC 28117-9543
Phone (828) 540-0112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
HC7552NCMDIn Home Supportive Care Agency

Practice roles

OrganizationSpecialtyStatusNew patients
MDC Global Care Solutions L.L.C Home Health CurrentSince Sep 1, 2024 Accepting new patients

Locations

131 Plantation Ridge Dr
Ste 305
Mooresville, NC 28117
Phone (828) 540-0112

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1063246882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 PLANTATION RIDGE DR STE 305",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179543",
            "telephone_number": "828-540-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 PLANTATION RIDGE DR STE 305",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179543",
            "telephone_number": "828-540-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANDOHAN",
        "first_name": "SYLVIE",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "HC7552",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NC",
            "license": "HC7552",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC7552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.