The Shepard's House, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

6601534 Issued in NC

Legal business name

THE SHEPARD'S HOUSE, LLC

Practice address

6612 E WT Harris Blvd
Suite I
Charlotte, NC 28215-5134

Phone

(704) 494-8712

Fax

(704) 494-8713

NPI assigned

Oct 20, 2006

Last updated

Jul 5, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Daryle Battle

Title

Agency Director

Phone

(704) 494-8712

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• GoodShepard In Home Health Care,LLC Former legal business name

Locations

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309824000000",
    "number": "1194807677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6612 E WT HARRIS BLVD",
            "address_2": "SUITE I",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282155134",
            "telephone_number": "704-494-8712",
            "fax_number": "704-494-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6612 E WT HARRIS BLVD",
            "address_2": "SUITE I",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282155134",
            "telephone_number": "704-494-8712",
            "fax_number": "704-494-8713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SHEPARD'S HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2011-07-05",
        "status": "A",
        "authorized_official_last_name": "BATTLE",
        "authorized_official_first_name": "DARYLE",
        "authorized_official_title_or_position": "AGENCY DIRECTOR",
        "authorized_official_telephone_number": "704-494-8712",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "6601534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418427",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601543",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GoodShepard In Home Health Care,LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Home Health Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Home Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; 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.