Organization Active NPI

Helms Rest Home

  • Assisted Living Facility
  • Waxhaw, NC
National Provider Identifier
1609966654
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
FCH-90-010 Issued in NC
Legal business name
HELMS REST HOME
Practice address
210 McCain St
Waxhaw, NC 28173-1038
Phone
(704) 843-2472
Fax
(704) 843-2555
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Edith H Wilson
Title
Co-Administrator
Phone
(704) 843-2472

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X FCH-90-010 NC Primary

Addresses

Primary practice location

210 McCain St
Waxhaw, NC 28173-1038

Mailing address

PO Box 44
210 MC Cain St
Waxhaw, NC 28173-1038
Phone (704) 843-2472

Other identifiers 1

IdentifierTypeStateIssuer
7803123MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1609966654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44",
            "address_2": "210 MC CAIN ST",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281731038",
            "telephone_number": "704-843-2472",
            "fax_number": "704-843-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MCCAIN ST",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281731038",
            "telephone_number": "704-843-2472",
            "fax_number": "704-843-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HELMS REST HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "EDITH",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CO-ADMINISTRATOR",
        "authorized_official_telephone_number": "704-843-2472"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "FCH-90-010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803123",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxhaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.