Organization Active NPI

Traditional Living Home Care Inc.

  • Home Health Agency
  • Wilkesboro, NC
National Provider Identifier
1942274097
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC2784 Issued in NC
Legal business name
TRADITIONAL LIVING HOME CARE INC.
Practice address
101 W Main St
Wilkesboro, NC 28697-2422
Phone
(336) 667-4546
Fax
(336) 667-2621
NPI assigned
Feb 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Authorized official

Name
Mrs. Lori R Gaughan
Title
Owner
Phone
(336) 667-4546

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC2784 NC Primary

Addresses

Primary practice location

101 W Main St
Wilkesboro, NC 28697-2422

Mailing address

1550 Overlook Dr
Wilkesboro, NC 28697-2610
Phone (336) 667-6447

Other identifiers 1

IdentifierTypeStateIssuer
6601897MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1942274097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 OVERLOOK DR",
            "city": "WILKESBORO",
            "state": "NC",
            "postal_code": "286972610",
            "telephone_number": "336-667-6447",
            "fax_number": "336-667-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W MAIN ST",
            "city": "WILKESBORO",
            "state": "NC",
            "postal_code": "286972422",
            "telephone_number": "336-667-4546",
            "fax_number": "336-667-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRADITIONAL LIVING HOME CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "GAUGHAN",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-667-4546",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC2784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601897",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkesboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.