NPIMap

Organization Active NPI

Omega Independent Living Services

  • In Home Supportive Care Agency
  • Raleigh, NC
National Provider Identifier
1083936686
Registry record updated Feb 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
OMEGA INDEPENDENT LIVING SERVICES
Practice address
3029 Stony Brook Dr Ste 105
Raleigh, NC 27604-3790
Phone
(919) 255-3268
Fax
(919) 250-2004
NPI assigned
Feb 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2010

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

Authorized official

Name
Mr. Donald K. Grantham
Title
Director of Operations
Phone
(919) 255-3268

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

3029 Stony Brook Dr Ste 105
Raleigh, NC 27604-3790

Mailing address

3029 Stony Brook Dr Ste 105
Raleigh, NC 27604-3790
Phone (919) 255-3268

Other identifiers 1

IdentifierTypeStateIssuer
8300455HMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Omega Independent Living Services Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266969600000",
    "number": "1083936686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3029 STONY BROOK DR STE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276043790",
            "telephone_number": "919-255-3268",
            "fax_number": "919-250-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3029 STONY BROOK DR STE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276043790",
            "telephone_number": "919-255-3268",
            "fax_number": "919-250-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA INDEPENDENT LIVING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-23",
        "last_updated": "2010-02-24",
        "status": "A",
        "authorized_official_last_name": "GRANTHAM",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "919-255-3268",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300455H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; 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.