NPIMap

Organization Active NPI

Avid Health at Home North Carolina

Doing business as Avid Health at Home NC

  • In Home Supportive Care Agency
  • Fayetteville, NC
National Provider Identifier
1225279508
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
HC1614 Issued in NC
Legal business name
AVID HEALTH AT HOME NORTH CAROLINA
Doing business as
Avid Health at Home NC
Practice address
2850 Village Dr Ste 204
Fayetteville, NC 28304-3864
Phone
(910) 500-1629
Fax
(901) 500-9282
NPI assigned
Mar 16, 2009
Last updated
Dec 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Jennifer Lentz
Title
Ceo
Phone
(516) 458-6769

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC1614 NC
Nursing Care Agency 251J00000X HC1614 NC
In Home Supportive Care Agency 253Z00000X HC1614 NC Primary

Addresses

Primary practice location

2850 Village Dr Ste 204
Fayetteville, NC 28304-3864

Mailing address

1508 Military Cutoff Rd Ste 304
Wilmington, NC 28403-5730
Phone (910) 362-9405

Other identifiers 1

IdentifierTypeStateIssuer
6601425MedicaidNC

Other names 1

  • Avid Health at Home NC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Avid Health at Home NC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2850 Village Dr
Ste 202
Fayetteville, NC 28304

NPI Registry JSON

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1225279508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 MILITARY CUTOFF RD STE 304",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035730",
            "telephone_number": "910-362-9405",
            "fax_number": "910-362-9948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 VILLAGE DR STE 204",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043864",
            "telephone_number": "910-500-1629",
            "fax_number": "901-500-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVID HEALTH AT HOME NORTH CAROLINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-16",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "LENTZ",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "516-458-6769"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC1614",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NC",
            "license": "HC1614",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "HC1614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601425",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avid Health at Home NC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.