Individual provider Active NPI

Kelechi Bassey

  • In Home Supportive Care Agency
  • Greenville, NC
National Provider Identifier
1245126663
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
HC7905 Issued in NC
Practice address
211 S Jarvis St Ste 104
Greenville, NC 27858-2052
Phone
(919) 349-2718
NPI assigned
Jun 13, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X HC7905 NC Primary

Addresses

Primary practice location

211 S Jarvis St Ste 104
Greenville, NC 27858-2052

Mailing address

8386 Six Forks Rd Ste 101
Raleigh, NC 27615-5088
Phone (872) 235-7194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
HC7905NCMDIn Home Supportive Care Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Angels Dome Home Healthcare Inc In Home Supportive Care CurrentSince Jun 23, 2025 Accepting new patients

Locations

211 S Jarvis St
Ste 104
Greenville, NC 27858
Phone (919) 349-2718

8386 Six Forks Rd
Ste 101
Raleigh, NC 27615
Phone (336) 933-1204

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1245126663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8386 SIX FORKS RD STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276155088",
            "telephone_number": "872-235-7194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S JARVIS ST STE 104",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278582052",
            "telephone_number": "919-349-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSEY",
        "first_name": "KELECHI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-13",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "HC7905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2025; 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.