Active NPI
Homecare Medical Groups LLC
- Durable Medical Equipment & Medical Supplies
- Wake Forest, NC
National Provider Identifier
1720273147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 000000
- Legal business name
- HOMECARE MEDICAL GROUPS LLC
- Practice address
- 10429 Ligon Mill Rd
Wake Forest, NC 27587-4987 - Phone
- (919) 556-7500
- Fax
- (888) 891-4170
- NPI assigned
- Sep 10, 2007
- Last updated
- Jul 21, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Bryan Tyson
- Title
- Registered Agent
- Phone
- (919) 494-2207
Specialties & licenses 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | NC | ||
| Developmentally Disabled Services Day Training Agency | 251C00000X | NC | ||
| Community Based Hospice Care Agency | 251G00000X | NC | ||
| Durable Medical Equipment & Medical Supplies | 332B00000X | 000000 | NC | Primary |
| Nursing Facility Supplies (DME) | 332BN1400X | 000000 | NC | |
| Oxygen Equipment & Supplies (DME) | 332BX2000X | 000000 | NC | |
| Home Delivered Meals | 332U00000X | 000000 | NC | |
| Prosthetic/Orthotic Supplier | 335E00000X | NU | ||
| Non-emergency Medical Transport (VAN) | 343900000X | NC | ||
| Early Intervention Provider Agency | 252Y00000X | NC | ||
| Local Education Agency (LEA) | 251300000X | NC | ||
| Community/Behavioral Health Agency | 251S00000X | NC |
Addresses
Primary practice location
10429 Ligon Mill Rd
Wake Forest, NC 27587-4987
Mailing address
10429 Ligon Mill Rd
Wake Forest, NC 27587-4987
Phone (919) 556-7500
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7790000 | Medicaid | NC | |
| BREAST PROSTHETICS | Other | NC | AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS |
| FEDERALLY ACCREDITED | Other | NC | HEALTHCARE QUALITY ASSOCIATION ON ACCREDITATION |
| CERTIFIED PEDORTHIST | Other | NC | AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS |
Other names 1
- Homecare Medical Groups LLC
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189382400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1311206400000",
"number": "1720273147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10429 LIGON MILL RD",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275874987",
"telephone_number": "919-556-7500",
"fax_number": "888-891-4170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10429 LIGON MILL RD",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275874987",
"telephone_number": "919-556-7500",
"fax_number": "888-891-4170"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOMECARE MEDICAL GROUPS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-09-10",
"last_updated": "2011-07-21",
"status": "A",
"authorized_official_last_name": "TYSON",
"authorized_official_first_name": "BRYAN",
"authorized_official_title_or_position": "REGISTERED AGENT",
"authorized_official_telephone_number": "919-494-2207",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NC",
"license": "000000",
"primary": true
},
{
"code": "332BN1400X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
"state": "NC",
"license": "000000",
"primary": false
},
{
"code": "332BX2000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
"state": "NC",
"license": "000000",
"primary": false
},
{
"code": "332U00000X",
"taxonomy_group": "",
"desc": "Home Delivered Meals",
"state": "NC",
"license": "000000",
"primary": false
},
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "251300000X",
"taxonomy_group": "",
"desc": "Local Education Agency (LEA)",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NC",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7790000",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS",
"identifier": "BREAST PROSTHETICS",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHCARE QUALITY ASSOCIATION ON ACCREDITATION",
"identifier": "FEDERALLY ACCREDITED",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS",
"identifier": "CERTIFIED PEDORTHIST",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Homecare Medical Groups LLC",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Wake Forest, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.