NPIMap

Organization Active NPI

Heritage Home Care of Greensboro Inc.

Doing business as Heritage Home Care Agency Inc.

  • In Home Supportive Care Agency
  • Charlotte, NC
National Provider Identifier
1720868912
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
HERITAGE HOME CARE OF GREENSBORO INC.
Doing business as
Heritage Home Care Agency Inc.
Practice address
1913 J N Pease PL Ste 103
Charlotte, NC 28262-4537
Phone
(704) 779-4667
NPI assigned
Oct 4, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

Name
Rico Akiva Wagner
Title
Owner
Phone
(704) 779-4667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

1913 J N Pease PL Ste 103
Charlotte, NC 28262-4537

Mailing address

1913 J N Pease PL Ste 103
Charlotte, NC 28262-4537
Phone (704) 779-4667

Other names 1

  • Heritage Home Care Agency Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heritage Home Care Agency Inc2 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.

NPI Registry JSON

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1720868912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 J N PEASE PL STE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624537",
            "telephone_number": "704-779-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 J N PEASE PL STE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624537",
            "telephone_number": "704-779-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE HOME CARE OF GREENSBORO INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-08-29",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "RICO",
        "authorized_official_middle_name": "AKIVA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-779-4667"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Home Care Agency Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.