NPIMap

Organization Active NPI

Support Staff Inc

  • Home Health Agency
  • Raleigh, NC
National Provider Identifier
1871617084
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC2558 Issued in NC
Legal business name
SUPPORT STAFF INC
Practice address
2805 Spring Forest Rd
Suite 201
Raleigh, NC 27616
Phone
(919) 790-1953
Fax
(919) 790-1963
NPI assigned
Mar 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Carley Jegbadai, RN
Title
Administrator
Phone
(919) 790-1953

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC2558 NC Primary

Addresses

Primary practice location

2805 Spring Forest Rd
Suite 201
Raleigh, NC 27616

Mailing address

2805 Spring Forest Rd
Suite 201
Raleigh, NC 27616-1899
Phone (919) 790-1953

Other identifiers 5

IdentifierTypeStateIssuer
6601352MedicaidNC
6601524MedicaidNC
6601157MedicaidNC
6601408MedicaidNC
6601351MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Support Staff Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

2805 Spring Forest Rd
Ste 201
Raleigh, NC 27616
Phone (919) 790-1953

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871617084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 SPRING FOREST RD",
            "address_2": "SUITE 201",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276161899",
            "telephone_number": "919-790-1953",
            "fax_number": "919-790-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 SPRING FOREST RD",
            "address_2": "SUITE 201",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27616",
            "telephone_number": "919-790-1953",
            "fax_number": "919-790-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORT STAFF INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JEGBADAI",
        "authorized_official_first_name": "CARLEY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-790-1953",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC2558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601352",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601524",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601157",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601408",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601351",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, 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.