NPIMap

Organization Active NPI

Angel Star Home Health, Inc.

  • Registered Nurse
  • Charlotte, NC
National Provider Identifier
1114948031
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
Legal business name
ANGEL STAR HOME HEALTH, INC.
Doing business as
Angel Star Home Health,Inc.
Practice address
5100 Reagan Dr
Suite 15
Charlotte, NC 28206-3190
Phone
(704) 596-0162
Fax
(704) 596-0869
NPI assigned
Jul 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Authorized official

Name
Mrs. Veronica Lavon McLendon
Title
Vice President of Operations
Phone
(704) 596-0162

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X Primary
Community Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WC1500X
Home Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WH0200X
Infusion Therapy Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WI0500X
Home Health Agency 251E00000X
Durable Medical Equipment & Medical Supplies 332B00000X 332B00000X NC
Personal Care AttendantGroup: 193200000X MULTI-SPECIALTY GROUP 3747P1801X
Home Health AideGroup: 193200000X MULTI-SPECIALTY GROUP 374U00000X
Nurse's AideGroup: 193200000X MULTI-SPECIALTY GROUP 376K00000X

Addresses

Primary practice location

5100 Reagan Dr
Suite 15
Charlotte, NC 28206-3190

Mailing address

9816 Nottinghill LN
Charlotte, NC 28269-5006
Phone (704) 596-0162

Other identifiers 4

IdentifierTypeStateIssuer
6106549MedicaidNCLICENSED CLINICAL SOCIAL
7704443MedicaidNCDME ID
3408430MedicaidNCCAPS
6006020MedicaidNCOUTPATIENT MENTAL HEALTH

Other names 1

  • Angel Star Home Health,Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Angel Star Home Health Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246233600000",
    "number": "1114948031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9816 NOTTINGHILL LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282695006",
            "telephone_number": "704-596-0162",
            "fax_number": "704-596-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 REAGAN DR",
            "address_2": "SUITE 15",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282063190",
            "telephone_number": "704-596-0162",
            "fax_number": "704-596-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL STAR HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2009-06-29",
        "status": "A",
        "authorized_official_last_name": "MCLENDON",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_middle_name": "LAVON",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "704-596-0162",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "332B00000X",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": "LICENSED CLINICAL SOCIAL",
            "identifier": "6106549",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": "DME ID",
            "identifier": "7704443",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": "CAPS",
            "identifier": "3408430",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": "OUTPATIENT MENTAL HEALTH",
            "identifier": "6006020",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angel Star Home Health,Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 29, 2009; 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.