NPIMap

Organization Active NPI

SPC Home Health LLC

Doing business as SPC Home Care

  • In Home Supportive Care Agency
  • Wilmington, NC
National Provider Identifier
1306271812
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
HC4101 Issued in NC
Legal business name
SPC HOME HEALTH LLC
Doing business as
SPC Home Care
Practice address
4910 Randall Pkwy
Wilmington, NC 28403-2827
Phone
(910) 395-8039
Fax
(910) 395-8381
NPI assigned
Sep 4, 2013
Last updated
Sep 4, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
SPC HOME HEALTH LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Authorized official

Name
Ms. Shakisha Nicole Brewington
Title
Owner/Business Manager
Phone
(910) 658-8525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X HC4101 NC Primary

Addresses

Primary practice location

4910 Randall Pkwy
Wilmington, NC 28403-2827

Mailing address

PO Box 3385
Wilmington, NC 28406-0385
Phone (910) 395-8039

Other identifiers 1

IdentifierTypeStateIssuer
3419242MedicaidNC

Other names 1

  • SPC Home Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
SPC Home Health LLC5 organizations share this tax ID, including this one
Part of
SPC Home Health LLC

Other organizations with this tax ID 4

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1306271812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3385",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284060385",
            "telephone_number": "910-395-8039",
            "fax_number": "910-395-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 RANDALL PKWY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032827",
            "telephone_number": "910-395-8039",
            "fax_number": "910-395-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPC HOME HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPC HOME HEALTH LLC",
        "enumeration_date": "2013-09-04",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "BREWINGTON",
        "authorized_official_first_name": "SHAKISHA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/BUSINESS MANAGER",
        "authorized_official_telephone_number": "910-658-8525",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "HC4101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3419242",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPC Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; 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.