My Pca- Triangle

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MY PCA- TRIANGLE

Practice address

5808 Knightdale Blvd Ste 202B
Knightdale, NC 27545-8654

Phone

(919) 720-1570

Fax

(252) 862-2987

NPI assigned

Sep 15, 2021

Last updated

Sep 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Kimberly San Holley

Title

Owner

Phone

(252) 558-8683

Specialties & licenses 1

Addresses

Electronic endpoints 2

Locations

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631664000000",
    "number": "1861162547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5808 KNIGHTDALE BLVD STE 202B",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275458654",
            "telephone_number": "919-720-1570",
            "fax_number": "252-862-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5808 KNIGHTDALE BLVD STE 202B",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275458654",
            "telephone_number": "919-720-1570",
            "fax_number": "252-862-2987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY PCA- TRIANGLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "HOLLEY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "SAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-558-8683",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kholley@mypcagreenville.com",
            "affiliation": "N",
            "endpointDescription": "kholley@mypcagreenville.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5808 Knightdale Blvd Ste 202B",
            "city": "Knightdale",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275458654",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://mypcagreenville.com/",
            "affiliation": "N",
            "endpointDescription": "desktop",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5808 Knightdale Blvd Ste 202B",
            "city": "Knightdale",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275458654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Home Health Agency in Knightdale, NC
• Providers in Knightdale, NC by specialty
• Home Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.