NPIMap

Organization Active NPI

Mga Home Healthcare Fayetteville, LLC

  • Nursing Care Agency
  • Fayetteville, NC
National Provider Identifier
1518613330
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
Legal business name
MGA HOME HEALTHCARE FAYETTEVILLE, LLC
Practice address
3400 Walsh Pkwy Ste 248
Fayetteville, NC 28311-1642
Phone
(910) 839-0239
Fax
(910) 900-0915
NPI assigned
Mar 2, 2022
Last updated
Mar 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Authorized official

Name
Wendy Chavez, MSN, RN
Title
VP, Operations
Phone
(910) 839-0239

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X Primary

Addresses

Primary practice location

3400 Walsh Pkwy Ste 248
Fayetteville, NC 28311-1642

Mailing address

3400 Walsh Pkwy Ste 248
Fayetteville, NC 28311-1642
Phone (910) 839-0239

Other identifiers 1

IdentifierTypeStateIssuer
HC6297MedicaidNC

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address wchavez@mgahomecare.com Direct
CONNECT URL mgahomecare.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Mga Home Healthcare Fayetteville LLC4 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.

NPI Registry JSON

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1518613330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 WALSH PKWY STE 248",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111642",
            "telephone_number": "910-839-0239",
            "fax_number": "910-900-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 WALSH PKWY STE 248",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111642",
            "telephone_number": "910-839-0239",
            "fax_number": "910-900-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGA HOME HEALTHCARE FAYETTEVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "CHAVEZ",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "VP, OPERATIONS",
        "authorized_official_telephone_number": "910-839-0239",
        "authorized_official_credential": "MSN, RN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC6297",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wchavez@mgahomecare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3400 Walsh Pkwy Ste 248",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283111642",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mgahomecare.com",
            "affiliation": "N",
            "endpointDescription": "org",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3400 Walsh Pkwy Ste 248",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283111642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.