Individual provider Active NPI

Debra Caprice Poore

  • In Home Supportive Care Agency
  • Camden, SC
National Provider Identifier
1508578758
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
221213-0916160 Issued in SC
Practice address
1388 Spring Hill Rd
Camden, SC 29020-9775
Phone
(803) 427-3654
NPI assigned
Dec 20, 2022
Last updated
Dec 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X 221213-0916160 SC
In Home Supportive Care Agency 253Z00000X 221213-0916160 SC Primary

Addresses

Primary practice location

1388 Spring Hill Rd
Camden, SC 29020-9775

Mailing address

1388 Spring Hill Rd
Camden, SC 29020-9775
Phone (803) 427-3654

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
221213-0916160SCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1671494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1508578758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1388 SPRING HILL RD",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290209775",
            "telephone_number": "803-427-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1388 SPRING HILL RD",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290209775",
            "telephone_number": "803-427-3654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POORE",
        "first_name": "DEBRA",
        "middle_name": "CAPRICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-20",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "SC",
            "license": "221213-0916160",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "SC",
            "license": "221213-0916160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.