NPIMap

Organization Active NPI

Community Home Care and Hospice, LLC

Doing business as Wake Forest Baptist Health Care at Home Hospice-Wilkes

  • Community Based Hospice Care Agency
  • Wilkesboro, NC
National Provider Identifier
1114661600
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
COMMUNITY HOME CARE AND HOSPICE, LLC
Doing business as
Wake Forest Baptist Health Care at Home Hospice-Wilkes
Practice address
126 Executive Dr Ste 110
Wilkesboro, NC 28697-7588
Phone
(336) 818-3177
NPI assigned
Apr 21, 2022
Last updated
Apr 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Authorized official

Name
Janet Combs
Title
VP, Licensure
Phone
(913) 814-2013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

126 Executive Dr Ste 110
Wilkesboro, NC 28697-7588

Mailing address

PO Box 4060
Mooresville, NC 28117-4060
Phone (704) 664-2876

Other identifiers 1

IdentifierTypeStateIssuer
1003236258MedicaidNC

Other names 1

  • Wake Forest Baptist Health Care at Home Hospice-Wilkes Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Atrium Health Wake Forest Baptist - Care4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

126 Executive Dr
Ste 110
Wilkesboro, NC 28697
Phone (336) 818-3177

NPI Registry JSON

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650499200000",
    "number": "1114661600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4060",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281174060",
            "telephone_number": "704-664-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 EXECUTIVE DR STE 110",
            "city": "WILKESBORO",
            "state": "NC",
            "postal_code": "286977588",
            "telephone_number": "336-818-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOME CARE AND HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-21",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-07",
        "status": "A",
        "authorized_official_last_name": "COMBS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "VP, LICENSURE",
        "authorized_official_telephone_number": "913-814-2013"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003236258",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wake Forest Baptist Health Care at Home Hospice-Wilkes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilkesboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.