RJR Kalli, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

RJR KALLI, LLC

Doing business as

RJR Kallie Healthcare

Practice address

113 N Railroad St
Magnolia, NC 28453

Phone

(919) 750-7195

NPI assigned

Jan 10, 2020

Last updated

Jan 13, 2020By 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

Keith Peten

Title

Agency Director

Phone

(919) 750-7195

Specialties & licenses 1

Addresses

Other names 1

• RJR Kallie Healthcare Doing business as

Tax ID family

RJR Kalli LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• RJR Kalli, LLC

  dba RJR Kallie Healthcare

  • In Home Supportive Care Agency
  • Winston Salem, NC
  • NPI 1578103081
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• RJR Kalli, LLC

  dba RJR Kallie Healthcare

  • In Home Supportive Care Agency
  • Winston Salem, NC
  • NPI 1578103081
  NPPES parent name

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578873600000",
    "number": "1972143600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 ELIZABETH ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275301940",
            "telephone_number": "919-750-7195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 N RAILROAD ST",
            "city": "MAGNOLIA",
            "state": "NC",
            "postal_code": "28453",
            "telephone_number": "919-750-7195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1114 Elizabeth St",
            "address_purpose": "LOCATION",
            "city": "Goldsboro",
            "state": "NC",
            "postal_code": "275301940",
            "country_code": "US",
            "telephone_number": "919-750-7195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RJR KALLI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A",
        "authorized_official_last_name": "PETEN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "AGENCY DIRECTOR",
        "authorized_official_telephone_number": "919-750-7195"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RJR Kallie Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RJR Kallie Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in Magnolia, NC
• Providers in Magnolia, 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 Jan 13, 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.