NPIMap

Organization Active NPI

Well Care Home Health of the Piedmont, Inc

  • Home Health Agency
  • Charlotte, NC
National Provider Identifier
1174009757
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
WELL CARE HOME HEALTH OF THE PIEDMONT, INC
Practice address
9300 Harris Corners Pkwy Ste 100
Charlotte, NC 28269-3802
Phone
(910) 362-9405
Fax
(910) 362-9948
NPI assigned
Jul 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Authorized official

Name
Lisa Moore
Title
Director of Revenue Cycle
Phone
(910) 362-9405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

9300 Harris Corners Pkwy Ste 100
Charlotte, NC 28269-3802

Mailing address

131 Racine Dr Ste 201
Wilmington, NC 28403-8752
Phone (910) 362-9405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190701001957 NC Part A Provider - Home Health Agency 2769716380 Practice locations: Huntersville, NC

Home health agency certification: CCN 347258

Legal name
WELL CARE HOME HEALTH OF THE PIEDMONT, INC.
Doing business as
WELL CARE HOME HEALTH OF THE PIEDMONT
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 4, 2019
Last certification
Dec 4, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Feb 27, 2017 in NC
Enrollment address
320 Seagle St
Ste 1
Huntersville, NC 28078-4337

Care Compare: Home health agency

Medicare Care Compare
Listed as
Well Care Home Health of Piedmont, Inc.CCN 347258
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Dec 4, 2019
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2164571Well Care Home Health of the Piedmont, Inc9300 Harris Corners Parkway, Suite 100, Charlotte, NC 28269Certificate of waiverApr 8, 2027

National Provider Directory

National Provider Directory

Locations

320 Seagle St
Ste 1
Huntersville, NC 28078
Phone (704) 512-0757

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John Chadwick Individual OtherChief Financial Officer Sep 1, 2019
Well Care Health, Inc. Organization, Wilmington, NC Corporation, LLC 5% Or Greater Direct Ownership Interest Nov 30, 2021 100%
Deborah R Chappell Individual W-2 Managing Employee Sep 9, 2009
Daniel Thompson Individual OtherVP Compliance and Quality Sep 1, 2019
Zachary Long Individual Corporate OfficerChief Executive Officer Oct 1, 2019
W-2 Managing EmployeeChief Executive Officer Oct 1, 2019
Long Family Ventures, LLC Organization, Raleigh, NC LLC 5% Or Greater Indirect Ownership Interest Nov 30, 2021 100%

Facilities with the same owner 10

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 28

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1174009757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 RACINE DR STE 201",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284038752",
            "telephone_number": "910-362-9405",
            "fax_number": "910-202-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 HARRIS CORNERS PKWY STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282693802",
            "telephone_number": "910-362-9405",
            "fax_number": "910-362-9948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL CARE HOME HEALTH OF THE PIEDMONT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "910-362-9405"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.