Individual provider Active NPI

Wilshawnda Squires

  • Home Health Aide
  • Fayetteville, NC
National Provider Identifier
1104798792
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HC8097 Issued in NC
Practice address
6200 Ramsey St
Fayetteville, NC 28311-9314
Phone
(910) 900-6003
Fax
(910) 900-7004
NPI assigned
Sep 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X HC8097 NC Primary

Addresses

Primary practice location

6200 Ramsey St
Fayetteville, NC 28311-9314

Mailing address

3771 Ramsey St Ste 109
Fayetteville, NC 28311-7616

Other names 1

  • Karmyce Quinn Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
HC8097NCMDHome Health Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Abundant Grace Home Health Services, LLC CurrentSince Sep 28, 2025 Accepting new patients

Locations

3771 Ramsey St
Ste 109
Fayetteville, NC 28311
Phone (301) 252-8600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1758499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1104798792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3771 RAMSEY ST STE 109",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283117616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283119314",
            "telephone_number": "910-900-6003",
            "fax_number": "910-900-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRES",
        "first_name": "WILSHAWNDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-22",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NC",
            "license": "HC8097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARMYCE",
            "last_name": "QUINN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; 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.