NPIMap

Organization Active NPI

Wake Forest Baptist Health Care at Home, LLC

Doing business as Wake Forest Bapatist Healthcare a Home, Community Care-Wilkes, Disable

  • Case Manager/Care Coordinator
  • North Wilkesboro, NC
National Provider Identifier
1235546623
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
WAKE FOREST BAPTIST HEALTH CARE AT HOME, LLC
Doing business as
Wake Forest Bapatist Healthcare a Home, Community Care-Wilkes, Disable
Practice address
56 Boone Trail
North Wilkesboro, NC 28659-3515
Phone
(336) 667-2208
NPI assigned
Jul 17, 2014
Last updated
May 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Janet Combs
Title
Vice President, Licensure
Phone
(913) 814-2013

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Durable Medical Equipment & Medical Supplies 332B00000X NU
Home Delivered Meals 332U00000X NU
Respite Care 385H00000X NU
In Home Supportive Care Agency 253Z00000X NU
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

56 Boone Trail
North Wilkesboro, NC 28659-3515

Mailing address

P.O. Box 4060
Attn: Regulatory
Mooresville, NC 28117-1157
Phone (704) 662-0416

Other identifiers 1

IdentifierTypeStateIssuer
1235546623MedicaidNC

Other names 1

  • Wake Forest Bapatist Healthcare a Home, Community Care-Wilkes, Disable Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Atrium Health Wake Forest Baptist - Care4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1235546623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 4060",
            "address_2": "ATTN: REGULATORY",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281171157",
            "telephone_number": "704-662-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 BOONE TRAIL",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593515",
            "telephone_number": "336-667-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE FOREST BAPTIST HEALTH CARE AT HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "COMBS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "VICE PRESIDENT, LICENSURE",
        "authorized_official_telephone_number": "913-814-2013"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235546623",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wake Forest Bapatist Healthcare a Home, Community Care-Wilkes, Disable",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Wilkesboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.