The 4C Company of NC, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

THE 4C COMPANY OF NC, LLC

Doing business as

4C Company of NC
4C Home Care

Practice address

246 Church St NE
Concord, NC 28025-4737

Phone

(980) 721-1573

NPI assigned

Jul 29, 2011

Last updated

Apr 13, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa M Wigfall, MSWNPI 1528305323

Title

Ceo

Phone

(704) 394-8968

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• 4C Company of NC Doing business as
• 4C Home Care Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Tax ID family

4C Integrated Health4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• The 4C Company of NC, LLC

  dba 4C Integrated Health

  • Community/Behavioral Health Agency
  • Concord, NC
  • NPI 1184479164
  NPD tax ID
• The 4C Company of NC, LLC

  dba 4C Integrated Health

  • Non-emergency Medical Transport (VAN)
  • Concord, NC
  • NPI 1417712555
  NPD tax ID
• The 4C Company of NC, LLC

  dba 4C Integrated Health

  • Primary Care Nurse Practitioner
  • Concord, NC
  • NPI 1932947165
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ramona Yvette Parker, DNP, FNP-C

  • Nurse Practitioner
  • Myrtle Beach, SC
  • NPI 1861852501

  NC

  Medicare reassignment NPD
• Lisa Wigfall, LCASA

  • Addiction (Substance Use Disorder) Counselor
  • Charlotte, NC
  • NPI 1528305323
  Authorized official Same address or phone

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618272000000",
    "number": "1457639031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3552 BEATTIES FORD RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282163742",
            "telephone_number": "704-394-8968",
            "fax_number": "704-394-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 CHURCH ST NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254737",
            "telephone_number": "980-721-1573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3552 Beatties Ford Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282163742",
            "country_code": "US",
            "telephone_number": "704-394-8968 x104",
            "fax_number": "704-394-8967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE 4C COMPANY OF NC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-29",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "WIGFALL",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-394-8968",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7806460",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "4C Company of NC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "4C Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nehal P. Thakkar, MD
• Siddarth Thakur, MD
• Der Thao
• The 4C Company of NC, LLC (4C Integrated Health)
• The 4C Company of NC, LLC (4C Integrated Health)
• The 4C Company of NC, LLC (4C Integrated Health)
• The Charlotte-Mecklenburg Hospital Authority (Atrium Health Primary Care and Integrative Medicine)
• The Charlotte-Mecklenburg Hospital Authority (Development & Behavioral Pediatrics of the Carolinas)
• The Charlotte-Mecklenburg Hospital Authority (Atrium Health Behavioral Health Psychiatry & Counseling)
• The Charlotte-Mecklenburg Hospital Authority (NorthEast Rheumatology)

• In Home Supportive Care Agency in Concord, NC
• Providers in Concord, 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 Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.