Tracie Lanae Pearsall

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

HC7292 Issued in NC

Practice address

12400 Wake Union Church Rd # 3-256
Wake Forest, NC 27587-4509

Phone

(919) 675-8937

NPI assigned

Jan 19, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Divine Innovation Services LLC

  • In Home Supportive Care Agency
  • Wake Forest, NC
  • NPI 1578324141
  NPD Authorized official

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1821859596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12400 WAKE UNION CHURCH RD # 3-256",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275874509",
            "telephone_number": "919-675-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 WAKE UNION CHURCH RD # 3-256",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275874509",
            "telephone_number": "919-675-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSALL",
        "first_name": "TRACIE",
        "middle_name": "LANAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "NC",
            "license": "HC7292",
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "NC",
            "license": "HC7292",
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "NC",
            "license": "HC7292",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NC",
            "license": "HC7292",
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NC",
            "license": "HC7292",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NC",
            "license": "HC7292",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NC",
            "license": "HC7292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Diane Patrone, FNP
• Kimberley Pavlak, LCMHC, LCAS
• Leslie Payne, MSW, LCSWA
• PC Consultants
• Megan Evans Pearce
• Janine Pearson, M.S., CCC-SLP
• Pediatrician'S Urgent Care
• Matthew Robert Pedone
• Peninsula Biomedical Inc
• Julie Marie Penner, PHARMD

• Home Health Aide in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Home Health Aide in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.