Organization Active NPI

CMT Home Health Agency

  • In Home Supportive Care Agency
  • Concord, NC
National Provider Identifier
1609163138
Registry record updated Jul 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
CMT HOME HEALTH AGENCY
Practice address
2604 S Ridge Ave
Concord, NC 28025-2852
Phone
(704) 262-6914
Fax
(800) 886-8442
NPI assigned
Jul 5, 2011
Last updated
Jul 5, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
CABARRUS-MECKLENBURG TRANSPORTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 5, 2011

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

Authorized official

Name
Augustine Kotee, OWNER
Title
Member
Phone
(704) 262-6914

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU
In Home Supportive Care Agency 253Z00000X NU Primary
In Home Supportive Care Agency 253Z00000X NC
PACE Provider Organization 251T00000X NU

Addresses

Primary practice location

2604 S Ridge Ave
Concord, NC 28025-2852

Mailing address

2604 S Ridge Ave
Concord, NC 28025-2852
Phone (704) 262-6914

Other identifiers 1

IdentifierTypeStateIssuer
3418940MedicaidNC

National Provider Directory

National Provider Directory
Part of
Cabarrus-Mecklenburg Transport LLC

Locations

2604 S Ridge Ave
Concord, NC 28025
Phone (704) 262-6914

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309824000000",
    "number": "1609163138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 S RIDGE AVE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252852",
            "telephone_number": "704-262-6914",
            "fax_number": "800-886-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 S RIDGE AVE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252852",
            "telephone_number": "704-262-6914",
            "fax_number": "800-886-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMT HOME HEALTH AGENCY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CABARRUS-MECKLENBURG TRANSPORT",
        "enumeration_date": "2011-07-05",
        "last_updated": "2011-07-05",
        "status": "A",
        "authorized_official_last_name": "KOTEE",
        "authorized_official_first_name": "AUGUSTINE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "704-262-6914",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418940",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; 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.