Well Care Home Health of the Southern Triangle, Inc.
Organization Active NPI Home Health Agency · Holly Springs, NC
NPI 1508418005 · NPPES record last updated Jun 6, 2025
Key facts
- NPI
- 1508418005
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- WELL CARE HOME HEALTH OF THE SOUTHERN TRIANGLE, INC.
- Practice address
- 4928 Linksland Dr Ste 340
Holly Springs, NC 27540-7455 - Phone
- (910) 362-9405
- NPI assigned
- Jul 15, 2019
- Organization subpart
- No
Authorized official
- Name
- Daniel Thompson
- Title
- VP, Compliance and Quality
- Phone
- (910) 362-9405
Facilities with the same owner 10
Affiliated clinicians 64
-
Nimia J Alston, MD
-
Samreen Azeem, M.D.
-
Paul L Burroughs, M.D. P.A
-
Nicole A Collins, MD
-
Patricia Ann Condon, FNP-C
-
Teablee Angell Corbett, FNP-C
-
Deepak Cuddapah, MD
-
Brette Whitney Daniels, DNP, APRN, FNP-BC
-
Thomas Scott Draughon, M.D.
-
Muin Mousa Dugom, M.D., FACP
-
Maria Fakadej, M.D.
-
Kusum Garg, M.D.
-
Raymond A Gaskins Jr., M.D.
-
Leah Marie Gruber, PA-C
-
Corrie Elizabeth Hansen, DNP, FNP-BC
Medicare Care Compare: Home health agency
- Listed as
- Well Care Home Health of the Southern Triangle, Inc.
- Overall star rating
- ★★★★★ 5 of 5
- Ownership
- -
- Certified
- Aug 16, 2021
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Home health agency certification: CCN 347336
- Legal name
- WELL CARE HOME HEALTH OF THE SOUTHERN TRIANGLE, INC.
- Doing business as
- WELL CARE HOME HEALTH OF THE SOUTHERN TRIANGLE
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Aug 16, 2021
- Last certification
- Aug 16, 2021
- Organization structure
- Corporation · Proprietary
- Incorporated
- Sep 19, 2018 in NC
- Enrollment address
- 4928 Linksland Dr
Ste 340
Holly Springs, NC 27540-7455
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| John Chadwick |
Corporate Director |
Sep 1, 2019 | |
| Operational/Managerial Control |
Sep 1, 2019 | ||
| Well Care Health, Inc. |
5% Or Greater Direct Ownership Interest | Nov 30, 2021 | 100% |
| Daniel Thompson |
Corporate Officer |
Sep 19, 2018 | |
| Other |
Oct 1, 2019 | ||
| Zachary Long |
Corporate Officer |
Sep 19, 2018 | |
| W-2 Managing Employee |
Sep 9, 2018 | ||
| Long Family Ventures, LLC |
5% Or Greater Indirect Ownership Interest | Nov 30, 2021 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200413001898 | NC | Part a Provider - Home Health Agency | 0648600734 | Practice locations: Holly Springs, NC |
National Provider Directory
Locations
106 N Johnson St
Ste A
Fuquay Varina, NC 27526
106 N Johnson St
Fuquay Varina, NC 27526
4928 Linksland Dr
Ste 340
Holly Springs, NC 27540
Phone (910) 362-9405
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
4928 Linksland Dr Ste 340
Holly Springs, NC 27540-7455
Mailing address
131 Racine Dr Ste 201
Wilmington, NC 28403-8752
Phone (910) 362-9405
Other providers in Holly Springs, NC
- Brett Walters
- Myla Deandra Ward
- Dana Rae Watkins
- Keri Elizabeth Weigle
- Mandi Sue Weiser
- Jolyn P Welsh
- Wendie Lubinsky Counseling PLLC
- Alexis Dontavia White
- Rebekah White
- Catherine Shumaker Whitman
All providers in Holly Springs, NC · Home Health Agency in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.