Mystar Healthcare

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

MYSTAR HEALTHCARE

Practice address

3749 Benson Dr # 104
Raleigh, NC 27609-7324

Phone

(919) 740-7462

Fax

(919) 964-3369

NPI assigned

May 4, 2020

Organization subpart

Yes

Parent organization

MYSTAR HEALTHCAREAs reported in NPPES

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

Authorized official

Name

Mr. Denis Anaezi Umelo

Title

Managing Director

Phone

(919) 740-7462

Specialties & licenses 1

Addresses

Other names 2

• Mystar, LLC Doing business as
• Mystar healthcare Other name

Part of

Mystar Healthcare

Locations

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

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1336760198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3749 BENSON DR # 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097324",
            "telephone_number": "919-740-7462",
            "fax_number": "919-964-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3749 BENSON DR # 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097324",
            "telephone_number": "919-740-7462",
            "fax_number": "919-964-3369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSTAR HEALTHCARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MYSTAR HEALTHCARE",
        "enumeration_date": "2020-05-04",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "UMELO",
        "authorized_official_first_name": "DENIS",
        "authorized_official_middle_name": "ANAEZI",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "919-740-7462",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mystar, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mystar healthcare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Raleigh, NC
• In Home Supportive Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.