Individual provider Active NPI

Vivian D Prince, LLC

  • In Home Supportive Care Agency
  • High Point, NC
National Provider Identifier
1558124693
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
HC5137 Issued in NC
Practice address
2004 Hunterwoods Dr
High Point, NC 27265-9573
Phone
(336) 681-8590
NPI assigned
Feb 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X
Meals Provider 174200000X
Rural Health Clinic/Center 261QR1300X HC5137 NC
Home Health Agency 251E00000X HC5137 NC
Health Service Clinic/Center 261QH0100X
Rural Health Clinic/Center 261QR1300X
Long Term Care Hospital 282E00000X
Nurse's Aide 376K00000X HC5137 NC
Adult Companion 372600000X
Home Health Aide 374U00000X
Home Health Aide 374U00000X HC5137 NC
Respite Care 385H00000X HC5137 NC
Child Physical Disabilities Respite Care 385HR2065X
In Home Supportive Care Agency 253Z00000X HC5137 NC Primary

Addresses

Primary practice location

2004 Hunterwoods Dr
High Point, NC 27265-9573

Mailing address

2004 Hunterwoods Dr
High Point, NC 27265-9573
Phone (336) 303-0292

Other names 1

  • Mrs. Vivian D Prince Professional name

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
HC5137NCMDNurse's Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Guided Living Senior Care LLC Home Health CurrentSince Feb 18, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1706745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1558124693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 HUNTERWOODS DR",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659573",
            "telephone_number": "336-303-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 HUNTERWOODS DR",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659573",
            "telephone_number": "336-681-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "VIVIAN",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "LLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-01",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NC",
            "license": "HC5137",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC5137",
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NC",
            "license": "HC5137",
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NC",
            "license": "HC5137",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NC",
            "license": "HC5137",
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "HC5137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIVIAN",
            "last_name": "PRINCE",
            "middle_name": "D",
            "prefix": "MRS.",
            "credential": "VIVIAN PRINCE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.