NPIMap

Organization Active NPI

Trisouth Health Services, Inc

  • Home Health Agency
  • Charlotte, NC
National Provider Identifier
1104001882
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
TRISOUTH HEALTH SERVICES, INC
Practice address
756 Tyvola Rd
Suite 143
Charlotte, NC 28217-3588
Phone
(704) 493-3422
NPI assigned
Dec 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2007

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

Authorized official

Name
Veronica Southerland, RN, BSW
Title
Administrator
Phone
(704) 493-3422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

756 Tyvola Rd
Suite 143
Charlotte, NC 28217-3588

Mailing address

PO Box 242036
Charlotte, NC 28224-2036
Phone (704) 493-3422

Other identifiers 1

IdentifierTypeStateIssuer
6601586MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Trisouth Health Services Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

Subparts reporting this organization as parent 5

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1104001882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 242036",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282242036",
            "telephone_number": "704-493-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "756 TYVOLA RD",
            "address_2": "SUITE 143",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173588",
            "telephone_number": "704-493-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISOUTH HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "SOUTHERLAND",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-493-3422",
        "authorized_official_credential": "RN, BSW"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601586",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; 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.