Beach Haven Home Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

BEACH HAVEN HOME CARE LLC

Practice address

4717 N Croatan Hwy Ste a
Kitty Hawk, NC 27949-8906

Phone

(252) 340-3150

NPI assigned

Jan 30, 2020

Last updated

Nov 27, 2023By 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

Brenda Wymer

Title

Ceo

Phone

(336) 572-0040

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1932730744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1227",
            "city": "SPARTA",
            "state": "NC",
            "postal_code": "286751227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4717 N CROATAN HWY STE A",
            "city": "KITTY HAWK",
            "state": "NC",
            "postal_code": "279498906",
            "telephone_number": "252-340-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACH HAVEN HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "WYMER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-572-0040"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Albemarle Physician Services - Sentara, Inc (Sentara Urgent Care)
• Albemarle Physician Services Inc. (Sentara Family Medicine Physicians)
• Katelyn Nicole Angelo, FNP
• Lauren Endee Baer, FNP-C
• Philip Francis Bald, D.M.D
• Beach Medical Care, LTD.
• Beach Medical PLLC
• Bear Drugs Inc (Bear Drugs of Kitty Hawk)
• Bear Drugs Inc.
• Jacquelyn Forrest Best

• In Home Supportive Care Agency in Kitty Hawk, NC
• Providers in Kitty Hawk, 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 Nov 27, 2023; 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.