NPIMap

Organization Active NPI

Deeply Rooted Home Care Incorporated

  • In Home Supportive Care Agency
  • Ahoskie, NC
National Provider Identifier
1194156265
Registry record updated Nov 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
HC2981 Issued in NC
Legal business name
DEEPLY ROOTED HOME CARE INCORPORATED
Practice address
124 Main St E
Ahoskie, NC 27910-3416
Phone
(252) 332-4409
Fax
(252) 332-5099
NPI assigned
Nov 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2013

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

Authorized official

Name
Phyllistine Simmons
Title
Owner
Phone
(252) 332-4409

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X HC2981 NC Primary

Addresses

Primary practice location

124 Main St E
Ahoskie, NC 27910-3416

Mailing address

124 Main St E
Ahoskie, NC 27910-3416
Phone (252) 332-4409

Other identifiers 1

IdentifierTypeStateIssuer
3408323MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Deeply Rooted Home Care Incorporated2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1385510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385510400000",
    "number": "1194156265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MAIN ST E",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279103416",
            "telephone_number": "252-332-4409",
            "fax_number": "252-332-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MAIN ST E",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279103416",
            "telephone_number": "252-332-4409",
            "fax_number": "252-332-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEPLY ROOTED HOME CARE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-27",
        "last_updated": "2013-11-27",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "PHYLLISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-332-4409"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "HC2981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408323",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ahoskie, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.