Intrepid of North Carolina Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HC0339 Issued in NC

Legal business name

INTREPID OF NORTH CAROLINA INC

Practice address

343 E Six Forks Rd Ste 130
Raleigh, NC 27609-7785

Phone

(919) 821-9299

Fax

(919) 835-0465

NPI assigned

Nov 22, 2005

Organization subpart

No

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

Authorized official

Name

Robert Parker

Title

Cco

Phone

(214) 445-3750

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Intrepid USA Healthcare Services Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1073596227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14841 DALLAS PKWY STE 625",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547641",
            "telephone_number": "214-445-3750",
            "fax_number": "214-445-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 E SIX FORKS RD STE 130",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097785",
            "telephone_number": "919-821-9299",
            "fax_number": "919-835-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTREPID OF NORTH CAROLINA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-22",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "214-445-3750"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC0339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3427009",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Intrepid USA Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intrepid USA Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Raleigh, NC
• Providers in Raleigh, 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 Nov 8, 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.