Phoenix Care Services Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PHOENIX CARE SERVICES INC.

Practice address

105B Preston Ave
Fayetteville, NC 28301-3455

Phone

(910) 709-0167

NPI assigned

Aug 17, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Tammie Sontrell Roberson

Title

Administrator

Phone

(910) 286-9197

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1336815653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 HOPE MILLS RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044243",
            "telephone_number": "910-709-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105B PRESTON AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013455",
            "telephone_number": "910-709-0167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX CARE SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "TAMMIE",
        "authorized_official_middle_name": "SONTRELL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-286-9197",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210608",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• 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 Oct 5, 2021; 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.