Mga Home Healthcare Fayetteville, LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

MGA HOME HEALTHCARE FAYETTEVILLE, LLC

Doing business as

MGA Homecare

Practice address

9101 Kings Parade Blvd
Suite 100
Charlotte, NC 28273-4068

Phone

(704) 200-9015

NPI assigned

Mar 29, 2021

Organization subpart

No

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

Authorized official

Name

Melody Beaty, MSN, RN

Title

VP Clinical Operations

Phone

(704) 200-9015

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• MGA Homecare Doing business as

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Mga Home Healthcare Fayetteville LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Mga Home Healthcare Fayetteville, LLC

  • Nursing Care Agency
  • Fayetteville, NC
  • NPI 1518613330
  NPD tax ID
• Mga Home Healthcare Fayetteville, LLC

  dba MGA Homecare

  • Nursing Care Agency
  • Winston Salem, NC
  • NPI 1639825458
  NPD tax ID
• Mga Home Healthcare Fayetteville, LLC

  dba MGA Homecare

  • Nursing Care Agency
  • Raleigh, NC
  • NPI 1659950442
  NPD tax ID

Locations

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1770160210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 KINGS PARADE BLVD",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282734068",
            "telephone_number": "704-200-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 KINGS PARADE BLVD",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282734068",
            "telephone_number": "704-200-9015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 South Stratford Rd, Building C",
            "address_2": "Suite 301",
            "address_purpose": "LOCATION",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27103",
            "country_code": "US",
            "telephone_number": "336-280-0435",
            "fax_number": "336-217-8746",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 Walsh Pkwy Ste 248",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283111642",
            "country_code": "US",
            "telephone_number": "910-839-0239",
            "fax_number": "910-900-0915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MGA HOME HEALTHCARE FAYETTEVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-29",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "BEATY",
        "authorized_official_first_name": "MELODY",
        "authorized_official_title_or_position": "VP CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "704-200-9015",
        "authorized_official_credential": "MSN, RN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC6135",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC6067",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC6297",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mgahomecare.com",
            "affiliation": "N",
            "endpointDescription": "mgahomecare.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9101 Kings Parade Blvd",
            "address_2": "Suite 100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282734068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MGA Homecare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MGA Homecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kayla Nicole Meyers, LCSWA
• Mollie Mitchell Meyers, CRNA
• Kimberly Hannah Meyran, NP
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• Carolyn Mitchell Miales, LPCA
• Lesia Mialik, NP

• Nursing Care Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Nursing Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.