Active NPI
Funke Yenrin Amanah
- In Home Supportive Care Agency
- Charlotte, NC
National Provider Identifier
1780294389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- HC5632
- Practice address
- 3555 N Sharon Amity Rd Ste 201
Charlotte, NC 28205-8993 - Phone
- (980) 498-2031
- NPI assigned
- Aug 7, 2020
- Last updated
- Aug 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | |||
| In Home Supportive Care Agency | 253Z00000X | HC5632 | NC | Primary |
Addresses
Primary practice location
3555 N Sharon Amity Rd Ste 201
Charlotte, NC 28205-8993
Mailing address
3555 N Sharon Amity Rd
Charlotte, NC 28205-8935
Phone (980) 498-2031
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HC5632 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| HC5632 | NC | MD | In Home Supportive Care Agency |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gifted Services LLC | In Home Supportive Care | Current | Accepting new patients |
Locations
3555 N Sharon Amity Rd
Charlotte, NC 28205
Phone (704) 536-8332
3555 N Sharon Amity Rd
Ste 201
Charlotte, NC 28205
Phone (773) 469-1576
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- In Home Supportive Care Agency
- Charlotte, NC
- NPI 1922607621
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596758400000",
"number": "1780294389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3555 N SHARON AMITY RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282058935",
"telephone_number": "980-498-2031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3555 N SHARON AMITY RD STE 201",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282058993",
"telephone_number": "980-498-2031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMANAH",
"first_name": "FUNKE",
"middle_name": "YENRIN",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-07",
"last_updated": "2020-08-07",
"certification_date": "2020-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "NC",
"license": "HC5632",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "HC5632",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
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- Amanda Linch DMD & Michael Reimels DDS PLLC
- Angela Amann
- J. Phoebe Amante, LCSW
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.