NPIMap

Organization Active NPI

Pelham Home Health Services, Inc

Doing business as Pelham Home Health

  • Home Health Agency
  • Fayetteville, NC
National Provider Identifier
1538230206
Registry record updated May 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC1859 Issued in NC
Legal business name
PELHAM HOME HEALTH SERVICES, INC
Doing business as
Pelham Home Health
Practice address
949 Country Club Dr
Fayetteville, NC 28301-2907
Phone
(910) 630-6757
Fax
(910) 884-9806
NPI assigned
Nov 13, 2006
Last updated
May 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2012

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

Authorized official

Name
Mildred C Wilson, RN, BSN
Title
Administrator
Phone
(910) 630-6757

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC1859 NC Primary
Home Health Agency 251E00000X HC2838 NC
Home Health Agency 251E00000X HC2268 NC
Home Health Agency 251E00000X HC2303 NC
Home Health Agency 251E00000X HC3189 NC

Addresses

Primary practice location

949 Country Club Dr
Fayetteville, NC 28301-2907

Mailing address

949 Country Club Dr
Fayetteville, NC 28301-2907
Phone (910) 630-6757

Other identifiers 6

IdentifierTypeStateIssuer
6600697MedicaidNC
6600905MedicaidNC
6601406MedicaidNC
3409245MedicaidNC
6600918MedicaidNC
6601211MedicaidNC

Other names 1

  • PELHAM HOME HEALTH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pelham Home Health6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337904000000",
    "number": "1538230206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 COUNTRY CLUB DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283012907",
            "telephone_number": "910-630-6757",
            "fax_number": "910-884-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 COUNTRY CLUB DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283012907",
            "telephone_number": "910-630-6757",
            "fax_number": "910-884-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELHAM HOME HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2012-05-25",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MILDRED",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-630-6757",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC1859",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC2838",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC2268",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC2303",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC3189",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600697",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600905",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601406",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409245",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600918",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601211",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PELHAM HOME HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 25, 2012; 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.