Organization Active NPI

Assured Extra Care Inc

  • Home Health Registered Nurse
  • Raleigh, NC
National Provider Identifier
1124696604
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
Legal business name
ASSURED EXTRA CARE INC
Practice address
5540 Centerview Dr Ste 200
Raleigh, NC 27606-3386
Phone
(832) 794-5177
NPI assigned
Jun 11, 2021
Organization subpart
Yes
Parent organization
ASSURED EXTRA CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Authorized official

Name
Omoyemi A Fasheun, CEO
Title
Administrator
Phone
(832) 794-5177

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Community Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WC1500X
Home Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WH0200X Primary
Feeding, Eating & Swallowing Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224ZF0002X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Home Health Agency 251E00000X
Home Infusion Agency 251F00000X
Nursing Care Agency 251J00000X
Physical Therapy Clinic/Center 261QP2000X
Home Health AideGroup: 193200000X MULTI-SPECIALTY GROUP 374U00000X
Respite Care 385H00000X

Addresses

Primary practice location

5540 Centerview Dr Ste 200
Raleigh, NC 27606-3386

Mailing address

12203 Resident Cir # 12203
Cary, NC 27519-9467
Phone (832) 794-5177

Other names 1

  • Assured Extra Care Inc Former legal business name

National Provider Directory

National Provider Directory
Part of
Assured Extra Care Inc

NPI Registry JSON

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623369600000",
    "number": "1124696604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12203 RESIDENT CIR # 12203",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275199467",
            "telephone_number": "832-794-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5540 CENTERVIEW DR STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276063386",
            "telephone_number": "832-794-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSURED EXTRA CARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASSURED EXTRA CARE INC",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A",
        "authorized_official_last_name": "FASHEUN",
        "authorized_official_first_name": "OMOYEMI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "832-794-5177",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": true
        },
        {
            "code": "224ZF0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant, Feeding, Eating & Swallowing",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "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": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Assured Extra Care Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.