Medicaid Travel, Inc.

Primary specialty

Lodging ProviderTaxonomy code 177F00000X

Legal business name

MEDICAID TRAVEL, INC.

Practice address

615 Saint George Square CT Ste 300
Winston Salem, NC 27103-1368

Phone

(919) 737-0734

Fax

(216) 250-8369

NPI assigned

Dec 30, 2019

Last updated

Jun 25, 2020By 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

Mr. Dylan Mack Carden

Title

Ceo

Phone

(919) 737-0734

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1528607207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SAINT GEORGE SQUARE CT STE 300",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031368",
            "telephone_number": "919-737-0734",
            "fax_number": "216-250-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SAINT GEORGE SQUARE CT STE 300",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031368",
            "telephone_number": "919-737-0734",
            "fax_number": "216-250-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAID TRAVEL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-30",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "CARDEN",
        "authorized_official_first_name": "DYLAN",
        "authorized_official_middle_name": "MACK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-737-0734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "medicaidtravel.com",
            "affiliation": "N",
            "endpointDescription": "url",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "615 Saint George Square Ct Ste 300",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271031368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Lodging Provider in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Lodging Provider in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; 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.