Organization Active NPI

Upper Level Home Care & Personal Care Services,LLC

  • Home Health Agency
  • Winston Salem, NC
National Provider Identifier
1386653202
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC3179 Issued in NC
Legal business name
UPPER LEVEL HOME CARE & PERSONAL CARE SERVICES,LLC
Practice address
3455 Polo Rd Ste 108
Winston Salem, NC 27106-4828
Phone
(336) 659-1901
Fax
(336) 768-1860
NPI assigned
Aug 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jessie Kelly-Holmes, RN,FNP
Title
Director
Phone
(336) 659-1901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC3179 NC Primary

Addresses

Primary practice location

3455 Polo Rd Ste 108
Winston Salem, NC 27106-4828

Mailing address

3455 Polo Rd Ste 108
Winston Salem, NC 27106-4828
Phone (336) 659-1901

Other identifiers 1

IdentifierTypeStateIssuer
6601396MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Upper Level Home Care Personal Care Servicesllc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3455 Polo Rd
Ste 108
Winston Salem, NC 27106
Phone (336) 659-1901

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386653202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 POLO RD STE 108",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064828",
            "telephone_number": "336-659-1901",
            "fax_number": "336-768-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 POLO RD STE 108",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064828",
            "telephone_number": "336-659-1901",
            "fax_number": "336-768-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER LEVEL HOME CARE & PERSONAL CARE SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLY-HOLMES",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-659-1901",
        "authorized_official_credential": "RN,FNP"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC3179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601396",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.