NPIMap

Organization Active NPI

Well Care Home Health of the Triangle

  • Home Health Agency
  • Raleigh, NC
National Provider Identifier
1811998990
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC0074 Issued in NC
Legal business name
WELL CARE HOME HEALTH OF THE TRIANGLE
Practice address
5400 Glenwood Ave Ste 310
Raleigh, NC 27612-3148
Phone
(919) 846-1018
Fax
(919) 846-5954
NPI assigned
Aug 10, 2005
Last updated
Jun 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Authorized official

Name
Lisa Moore
Title
Director of Revenue Cycle
Phone
(910) 362-9405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC0074 NC Primary

Addresses

Primary practice location

5400 Glenwood Ave Ste 310
Raleigh, NC 27612-3148

Mailing address

131 Racine Dr Ste 201
Wilmington, NC 28403-8752
Phone (910) 362-9405

Other identifiers 1

IdentifierTypeStateIssuer
3407192MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120723000368 NC Part A Provider - Home Health Agency 8628234564 Practice locations: Raleigh, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811998990. Details of each certification follow.

Home health agency certification: CCN 347192

Legal name
WELL CARE HOME HEALTH OF THE TRIANGLE
Doing business as
WELL CARE HOME HEALTH OF THE TRIANGLE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 18, 1992
Last certification
Sep 30, 2017
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jan 19, 2012 in NC
Enrollment address
5400 Glenwood Ave
Ste 310
Raleigh, NC 27612-3148
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Well Care Home Health, IncCCN 347192 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Jun 18, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
At Home Quality Care 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.

Locations

7721 Six Forks Rd
Ste 130
Raleigh, NC 27615
Phone (919) 846-1018

8025 Creedmoor Rd
Ste 200
Raleigh, NC 27613
Phone (919) 676-7575

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John Chadwick Individual Corporate OfficerChief Financial Officer Sep 1, 2019
Operational/Managerial ControlChief Financial Officer Oct 1, 2019
Well Care Health, Inc. Organization, Wilmington, NC Corporation 5% Or Greater Direct Ownership Interest Nov 30, 2021 100%
Deborah R Chappell Individual W-2 Managing Employee Sep 9, 2009
Daniel Thompson Individual W-2 Managing EmployeeDelegated Official Oct 1, 2019
Operational/Managerial ControlVice President,Compliance & Quality Oct 1, 2019
Zachary Long Individual Corporate OfficerChief Executive Officer Oct 1, 2019
W-2 Managing EmployeeChief Executive Officer Oct 1, 2017
Long Family Ventures, LLC Organization, Raleigh, NC LLC 5% Or Greater Indirect Ownership Interest Nov 30, 2021 100%

Facilities with the same owner 10

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 34

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1811998990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 RACINE DR STE 201",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284038752",
            "telephone_number": "910-362-9405",
            "fax_number": "910-202-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 GLENWOOD AVE STE 310",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123148",
            "telephone_number": "919-846-1018",
            "fax_number": "919-846-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL CARE HOME HEALTH OF THE TRIANGLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-10",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "910-362-9405"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC0074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3407192",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.