NPIMap

Individual provider Active NPI

Charles Graham

  • Personal Care Attendant
  • Lumberton, NC
National Provider Identifier
1750420618
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
HC1604 Issued in NC
Practice address
4820 Fayetteville Rd
Lumberton, NC 28358-2112
Phone
(910) 608-0430
Fax
(910) 608-0464
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X HC1604 NC Primary

Addresses

Primary practice location

4820 Fayetteville Rd
Lumberton, NC 28358-2112

Mailing address

4820 Fayetteville Rd
Lumberton, NC 28358-2112
Phone (910) 608-0430

Other identifiers 1

IdentifierTypeStateIssuer
3408879MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
HC1604NCMDPersonal Care Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
Companion Home Care Unimed Inc. Past Accepting new patients
Companion Home Care Unimed Inc. Past Accepting new patients
Companion Home Health Care Past Accepting new patients
Companion Home Care Past Accepting new patients
Companion Home Care Unime Inc. Past Accepting new patients
Companion Home Care-Unimed Inc PastSince Sep 16, 2013 Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1750420618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 FAYETTEVILLE RD",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582112",
            "telephone_number": "910-608-0430",
            "fax_number": "910-608-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 FAYETTEVILLE RD",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582112",
            "telephone_number": "910-608-0430",
            "fax_number": "910-608-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NC",
            "license": "HC1604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408879",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.