NPIMap

Organization Active NPI

Managed Care Diversified Home Care Services

  • In Home Supportive Care Agency
  • Tarboro, NC
National Provider Identifier
1710579016
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
MANAGED CARE DIVERSIFIED HOME CARE SERVICES
Doing business as
Managed Care Diversified Home Care Services
Practice address
1600 Western Blvd
Suite #31
Tarboro, NC 27886-2788
Phone
(252) 641-6885
Fax
(252) 641-5889
NPI assigned
Feb 8, 2021
Last updated
May 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Authorized official

Name
Mr. Michael Corbett DawesNPI 1417548553
Title
Director
Phone
(252) 641-6885

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

1600 Western Blvd
Suite #31
Tarboro, NC 27886-2788

Mailing address

PO Box 602
Tarboro, NC 27886-0602
Phone (252) 641-6885

Other names 1

  • Managed Care Diversified Home Care Services Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620691200000",
    "number": "1710579016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278860602",
            "telephone_number": "252-641-6885",
            "fax_number": "252-641-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 WESTERN BLVD",
            "address_2": "SUITE #31",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278862788",
            "telephone_number": "252-641-6885",
            "fax_number": "252-641-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANAGED CARE DIVERSIFIED HOME CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A",
        "authorized_official_last_name": "DAWES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "CORBETT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "252-641-6885",
        "authorized_official_name_prefix": "Mr."
    },
    "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Managed Care Diversified Home Care Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Managed Care Diversified Home Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tarboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.