NPIMap

Organization Active NPI

Extensions of Living, L.L.C.

  • Home Health Agency
  • Fayetteville, NC
National Provider Identifier
1982829453
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC3021 Issued in NC
Legal business name
EXTENSIONS OF LIVING, L.L.C.
Practice address
4939 Bragg Blvd
Suite #202
Fayetteville, NC 28303-3686
Phone
(910) 485-8370
Fax
(252) 514-2770
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Monique Alexandria Robinson, ADMINISTRATOR
Title
Billing Officer Staff Nurse
Phone
(252) 514-2727

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC3021 NC Primary

Addresses

Primary practice location

4939 Bragg Blvd
Suite #202
Fayetteville, NC 28303-3686

Mailing address

4939 Bragg Blvd
Suite #202
Fayetteville, NC 28303-3686
Phone (910) 485-8370

Other identifiers 1

IdentifierTypeStateIssuer
HC3021MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Extensions of Living LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

4939 Bragg Blvd
Ste 202
Fayetteville, NC 28303
Phone (910) 485-8370

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982829453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4939 BRAGG BLVD",
            "address_2": "SUITE #202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033686",
            "telephone_number": "910-485-8370",
            "fax_number": "252-514-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4939 BRAGG BLVD",
            "address_2": "SUITE #202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033686",
            "telephone_number": "910-485-8370",
            "fax_number": "252-514-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENSIONS OF LIVING, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_middle_name": "ALEXANDRIA",
        "authorized_official_title_or_position": "BILLING OFFICER STAFF NURSE",
        "authorized_official_telephone_number": "252-514-2727",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC3021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC3021",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.