NPIMap

Organization Active NPI

North Carolina Outreach Home Care, LLC

  • Community/Behavioral Health Agency
  • Pisgah Forest, NC
National Provider Identifier
1124407614
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL-088-030 Issued in NC
Legal business name
NORTH CAROLINA OUTREACH HOME CARE, LLC
Practice address
3431 Asheville Hwy
Pisgah Forest, NC 28768-8771
Phone
(828) 877-2112
NPI assigned
May 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Authorized official

Name
Shannon Durbin
Title
Chief Quality Officer
Phone
(901) 410-9058

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL-088-030 NC Primary
In Home Supportive Care Agency 253Z00000X MHL-088-030 NC

Addresses

Primary practice location

3431 Asheville Hwy
Pisgah Forest, NC 28768-8771

Mailing address

3431 Asheville Hwy
Pisgah Forest, NC 28768-8771
Phone (828) 877-2112

Other identifiers 1

IdentifierTypeStateIssuer
3409530MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
North Carolina Outreach Home Care LLC4 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.

NPI Registry JSON

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

{
    "created_epoch": "1432857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432857600000",
    "number": "1124407614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3431 ASHEVILLE HWY",
            "city": "PISGAH FOREST",
            "state": "NC",
            "postal_code": "287688771",
            "telephone_number": "828-877-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3431 ASHEVILLE HWY",
            "city": "PISGAH FOREST",
            "state": "NC",
            "postal_code": "287688771",
            "telephone_number": "828-877-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA OUTREACH HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-29",
        "last_updated": "2015-05-29",
        "status": "A",
        "authorized_official_last_name": "DURBIN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "CHIEF QUALITY OFFICER",
        "authorized_official_telephone_number": "901-410-9058"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-088-030",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "MHL-088-030",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409530",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pisgah Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.