NPIMap

Organization Active NPI

Vistelan, LLC

  • In Home Supportive Care Agency
  • Summerville, SC
National Provider Identifier
1144679234
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
IHCP-0024 Issued in SC
Legal business name
VISTELAN, LLC
Practice address
208 N Cedar St Unit B
Summerville, SC 29483-6451
Phone
(843) 771-0292
Fax
(888) 554-0253
NPI assigned
Jun 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Authorized official

Name
Larry Brian Pridemore
Title
VP of Operations
Phone
(843) 771-0292

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X IHCP-0024 SC Primary

Addresses

Primary practice location

208 N Cedar St Unit B
Summerville, SC 29483-6451

Mailing address

208 N Cedar St Unit B
Summerville, SC 29483-6451
Phone (843) 771-0292

National Provider Directory

National Provider Directory

Locations

208 N Cedar St
Unit B
Summerville, SC 29483
Phone (843) 771-0292

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1144679234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 N CEDAR ST UNIT B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836451",
            "telephone_number": "843-771-0292",
            "fax_number": "888-554-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 N CEDAR ST UNIT B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836451",
            "telephone_number": "843-771-0292",
            "fax_number": "888-554-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTELAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "PRIDEMORE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "843-771-0292"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "SC",
            "license": "IHCP-0024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.