Granville-Vance District Health Department

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GRANVILLE-VANCE DISTRICT HEALTH DEPARTMENT

Doing business as

Granville-Vance Home Health Agency

Practice address

125 Charles Rollins Road
Henderson, NC 27536-0000

Phone

(252) 492-5831

NPI assigned

Jan 25, 2007

Last updated

Dec 15, 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

Dr. Wilton Rodwell Drake Jr., MDNPI 1801941018

Title

Health Director

Phone

96196932141

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Granville-Vance Home Health Agency Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Home Health and Hospice Care, Inc.

  dba 3HC

  • Home Health Agency
  • Henderson, NC
  • NPI 1780193128

  Sold to, 2017-10-01

  CMS change of ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wilton Rodwell Drake Jr., MD

  • General Practice Physician
  • Oxford, NC
  • NPI 1801941018
  Authorized official Same address or phone

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323907200000",
    "number": "1275689242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HUNT ST",
            "address_2": "PO BOX 367",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275653414",
            "telephone_number": "919-693-2141",
            "fax_number": "919-693-8517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CHARLES ROLLINS ROAD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275360000",
            "telephone_number": "252-492-5831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANVILLE-VANCE DISTRICT HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2011-12-15",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "WILTON",
        "authorized_official_middle_name": "RODWELL",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "96196932141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "34D1034140",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "HC0501",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3407062",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granville-Vance Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard A Goldstein, MD
• Good News Health Care, Inc (Good News Home Care)
• James Oscar Goodwin, MD
• Crystal Parker Grant
• Granville Vance Community Health Inc. (Clinical Services)
• Nancy Gray-Terry, MSW, LCSW
• Brandon S Gray, COHC
• Lara Royster Gray, AU.D.
• Green & Co. Wellness Collective, PLLC
• Green Rural Redevelopment Organization

• Home Health Agency in Henderson, NC
• Providers in Henderson, 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 Dec 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.