Kween5464 Corporation

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

KWEEN5464 CORPORATION

Practice address

1826 E 4TH St
Winston Salem, NC 27101-4606

Phone

(336) 582-9156

Fax

(888) 682-1348

NPI assigned

Apr 1, 2020

Organization subpart

Yes

Parent organization

KWEEN5464 CORPORATIONAs reported in NPPES

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

Authorized official

Name

Ms. Kimberly Pettigrew

Title

Owner/Director

Phone

(336) 582-9156

Specialties & licenses 1

Addresses

Other names 1

• At Home Eldercare of Winston Salem Doing business as

Part of

Kween5464 Corporation

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628467200000",
    "number": "1912535097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 561",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271020561",
            "telephone_number": "336-582-9156",
            "fax_number": "888-682-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 E 4TH ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271014606",
            "telephone_number": "336-582-9156",
            "fax_number": "888-682-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KWEEN5464 CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KWEEN5464 CORPORATION",
        "enumeration_date": "2020-04-01",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "PETTIGREW",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "336-582-9156",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "At Home Eldercare of Winston Salem",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "At Home Eldercare of Winston Salem",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey G Kuremsky, MD
• Kimberly Kurz
• Michael Anthony Kutcher, MD
• Carrie Kuyper
• Duaa Kuziez, MD
• Evelyn Chang Kwok, M.D.
• Belinda Kyeiwah Kyere
• Kyle Taylor DDS PLLC
• Kyle Taylor, DDS III, PLLC
• Victoria Jane Kyle, CCC-SLP

• In Home Supportive Care Agency in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• In Home Supportive Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.