NPIMap

Organization Active NPI

Pine Haven Home Health Care Services Inc

  • Home Health Agency
  • Kinston, NC
National Provider Identifier
1861544579
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC1411 Issued in NC
Legal business name
PINE HAVEN HOME HEALTH CARE SERVICES INC
Practice address
1108 N Herritage St
Kinston, NC 28501-3834
Phone
(252) 523-1963
Fax
(252) 523-1123
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Evelyn J. Russell, R.N.
Title
Director
Phone
(252) 523-1963

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC1411 NC Primary

Addresses

Primary practice location

1108 N Herritage St
Kinston, NC 28501-3834

Mailing address

1108 N Herritage St
Kinston, NC 28501-3834
Phone (252) 523-1963

Other identifiers 4

IdentifierTypeStateIssuer
3408724MedicaidNC
6600438MedicaidNC
6600841MedicaidNC
6600889MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Pine Haven Home Health Care Services Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861544579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 N HERRITAGE ST",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285013834",
            "telephone_number": "252-523-1963",
            "fax_number": "252-523-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 N HERRITAGE ST",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285013834",
            "telephone_number": "252-523-1963",
            "fax_number": "252-523-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE HAVEN HOME HEALTH CARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "252-523-1963",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC1411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408724",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600438",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600841",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600889",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinston, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.