NPIMap

Organization Active NPI

Express Support Group, LLC

  • In Home Supportive Care Agency
  • Raleigh, NC
National Provider Identifier
1104240936
Registry record updated Feb 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
HC 4472 Issued in NC
Legal business name
EXPRESS SUPPORT GROUP, LLC
Practice address
1801 Saint Albans Dr Ste G
Raleigh, NC 27609-6286
Phone
(919) 876-4949
Fax
(919) 876-4946
NPI assigned
Feb 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2014

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

Authorized official

Name
Patrick I Ogbonna
Title
President
Phone
(919) 876-4949

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X HC 4472 NC Primary

Addresses

Primary practice location

1801 Saint Albans Dr Ste G
Raleigh, NC 27609-6286

Mailing address

1801 Saint Albans Dr Ste G
Raleigh, NC 27609-6286
Phone (919) 876-4949

Other names 1

  • EXPRESS HOME CARE- WILMINGTON Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Express Home Care- Wilmington2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1392336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392336000000",
    "number": "1104240936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 SAINT ALBANS DR STE G",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096286",
            "telephone_number": "919-876-4949",
            "fax_number": "919-876-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SAINT ALBANS DR STE G",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096286",
            "telephone_number": "919-876-4949",
            "fax_number": "919-876-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS SUPPORT GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-14",
        "last_updated": "2014-02-14",
        "status": "A",
        "authorized_official_last_name": "OGBONNA",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-876-4949"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "HC 4472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EXPRESS HOME CARE- WILMINGTON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 14, 2014; 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.