NPIMap

Individual provider Active NPI

Joan H Hicks, AGENCY DIRECTOR

  • In Home Supportive Care Agency
  • Oxford, NC
National Provider Identifier
1124325782
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
HC4295 Issued in NC
Practice address
1213 Goshen St
Suite B
Oxford, NC 27565-9313
Phone
(919) 603-0661
Fax
(919) 603-1661
NPI assigned
Feb 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X HC4295 NC
Case Management Agency 251B00000X HC4295 NC
In Home Supportive Care Agency 253Z00000X HC4295 NC Primary
Nursing Care Agency 251J00000X HC4295 NC

Addresses

Primary practice location

1213 Goshen St
Suite B
Oxford, NC 27565-9313

Mailing address

1213 Goshen St
Suite B
Oxford, NC 27565-9313
Phone (919) 603-0661

Other identifiers 1

IdentifierTypeStateIssuer
HC4296OtherNCHOME CARE SERVICES NC DHHS DIVISION OF HEALTH SERVICES REGULATIONS

Other names 1

  • Four H Home Care Agency 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
HC4295NCMDPersonal Care Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
Four H Home Care Agency Case Management Past Accepting new patients
Inspire Home Care Services, LLC In Home Supportive Care Past Accepting new patients

Organizations & group practices 2

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": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1124325782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 GOSHEN ST",
            "address_2": "SUITE B",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275659313",
            "telephone_number": "919-603-0661",
            "fax_number": "919-603-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 GOSHEN ST",
            "address_2": "SUITE B",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275659313",
            "telephone_number": "919-603-0661",
            "fax_number": "919-603-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "JOAN",
        "middle_name": "H",
        "credential": "AGENCY DIRECTOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NC",
            "license": "HC4295",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": "HC4295",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "HC4295",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NC",
            "license": "HC4295",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME CARE SERVICES NC DHHS DIVISION OF HEALTH SERVICES REGULATIONS",
            "identifier": "HC4296",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FOUR H",
            "last_name": "CARE AGENCY",
            "middle_name": "HOME",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Oxford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; 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.