NPIMap

Organization Active NPI

Independent Life Health System

  • In Home Supportive Care Agency
  • Gastonia, NC
National Provider Identifier
1922474295
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
HC4789 Issued in NC
Legal business name
INDEPENDENT LIFE HEALTH SYSTEM
Practice address
1006 Union Rd
A
Gastonia, NC 28054-0466
Phone
(954) 479-9856
NPI assigned
Aug 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Authorized official

Name
Johnathaun Lee
Title
Owner
Phone
(954) 479-9856

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X HC4789 NC Primary

Addresses

Primary practice location

1006 Union Rd
A
Gastonia, NC 28054-0466

Mailing address

1006 Union Rd
A
Gastonia, NC 28054-0466

Other identifiers 1

IdentifierTypeStateIssuer
HC4789OtherNCDMA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1922474295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 UNION RD",
            "address_2": "A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280540466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 UNION RD",
            "address_2": "A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280540466",
            "telephone_number": "954-479-9856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT LIFE HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JOHNATHAUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-479-9856"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "HC4789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMA",
            "identifier": "HC4789",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.