NPIMap

Organization Active NPI

Pelna LLC

  • In Home Supportive Care Agency
  • Fort Mill, SC
National Provider Identifier
1447845102
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
PELNA LLC
Practice address
2012 Highway 160 W Ste 19
Fort Mill, SC 29708-8401
Phone
(757) 717-8922
NPI assigned
Mar 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Authorized official

Name
Moyosore Agiri
Title
Adminstrator
Phone
(757) 288-3604

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary
Personal Care AttendantGroup: 193400000X SINGLE SPECIALTY GROUP 3747P1801X

Addresses

Primary practice location

2012 Highway 160 W Ste 19
Fort Mill, SC 29708-8401

Mailing address

2012 Highway 160 W Ste 19
Fort Mill, SC 29708-8401
Phone (757) 717-8922

National Provider Directory

National Provider Directory
Tax ID family
Pelna LLC2 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.

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": "1614816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1447845102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 HIGHWAY 160 W STE 19",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088401",
            "telephone_number": "757-717-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 HIGHWAY 160 W STE 19",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088401",
            "telephone_number": "757-717-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELNA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "AGIRI",
        "authorized_official_first_name": "MOYOSORE",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "757-288-3604"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

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