Organization Active NPI

NC-Vital Healthcare Inc.

  • Home Health Agency
  • Garland, TX
National Provider Identifier
1407048291
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
011866 Issued in TX
Legal business name
NC-VITAL HEALTHCARE INC.
Practice address
337 Oaks TRL
Suite 105
Garland, TX 75043-4096
Phone
(214) 484-3163
Fax
(214) 484-3257
NPI assigned
Aug 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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

Authorized official

Name
Mrs. Vivian Elegonye, RNNPI 1144411588
Title
Administrator
Phone
(214) 437-9530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 011866 TX Primary

Addresses

Primary practice location

337 Oaks TRL
Suite 105
Garland, TX 75043-4096

Mailing address

337 Oaks TRL
Suite 105
Garland, TX 75043-4096
Phone (214) 484-3163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Locations

2824 Terrell Rd
Ste 202
Greenville, TX 75402
Phone (469) 826-9812

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Oct 3, 2016 Change of OwnershipThis provider was the seller Family First Home Health LLCCCN 747238, TX, NPI 1114471950

Change of ownership 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412812800000",
    "number": "1407048291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 OAKS TRL",
            "address_2": "SUITE 105",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750434096",
            "telephone_number": "214-484-3163",
            "fax_number": "214-484-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 OAKS TRL",
            "address_2": "SUITE 105",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750434096",
            "telephone_number": "214-484-3163",
            "fax_number": "214-484-3257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NC-VITAL HEALTHCARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2014-10-09",
        "status": "A",
        "authorized_official_last_name": "ELEGONYE",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "214-437-9530",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "011866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.