Providence Healthcare, Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PROVIDENCE HEALTHCARE, INC.

Practice address

3708 Mayfair St
100
Durham, NC 27707-6226

Phone

(919) 246-4426

NPI assigned

Mar 6, 2010

Last updated

Jul 13, 2011By 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

Simone McCrea

Title

Ceo/President

Phone

(919) 246-4446

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1267833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310515200000",
    "number": "1093038929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 MAYFAIR ST",
            "address_2": "100",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076226",
            "telephone_number": "919-246-4426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 MAYFAIR ST",
            "address_2": "100",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076226",
            "telephone_number": "919-246-4426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-06",
        "last_updated": "2011-07-13",
        "status": "A",
        "authorized_official_last_name": "MCCREA",
        "authorized_official_first_name": "SIMONE",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "919-246-4446"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Durham, NC
• Providers in Durham, NC by specialty
• In Home Supportive Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.