Carolina Personal Care Agency LLC

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

HC2980 Issued in NC

Legal business name

CAROLINA PERSONAL CARE AGENCY LLC

Practice address

919 Rowan Rd
Clinton, NC 28328-0872

Phone

(910) 590-2480

Fax

(910) 592-2718

NPI assigned

Jan 12, 2007

Last updated

Aug 22, 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

Mrs. Karen Alice Moore, RN

Title

Director RN

Phone

(910) 590-2480

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Carolina Personal Care Agency LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Carolina Personal Care Agency, LLC

  • Nurse's Aide
  • Clinton, NC
  • NPI 1558400945
  NPD tax ID

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1588714232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 ROWAN RD",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283280872",
            "telephone_number": "910-590-2480",
            "fax_number": "910-592-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 ROWAN RD",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283280872",
            "telephone_number": "910-590-2480",
            "fax_number": "910-592-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA PERSONAL CARE AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "ALICE",
        "authorized_official_title_or_position": "DIRECTOR RN",
        "authorized_official_telephone_number": "910-590-2480",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NC",
            "license": "HC2980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601295",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Choice LLC
• Carolina Coast Emergency Physicians LLC
• Carolina Eye Care Professionals, PA
• Carolina Eye Care Professionals, PA
• Carolina Home Medical, Inc.
• Carolina Personal Care Agency, LLC
• Carolina Residential Services, Inc
• Carolina Residential Services, Inc.
• Carolina Urology Healthcare, PLLC
• William C. Carr, MD

• Nurse's Aide in Clinton, NC
• Providers in Clinton, NC by specialty
• Nurse's Aide in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.