Mayos Loving Care Adult Group Home

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

MHL064115 Issued in NC

Legal business name

MAYOS LOVING CARE ADULT GROUP HOME

Practice address

105 Krista LN
Rocky Mount, NC 27803-5228

Phone

(252) 973-8593

Fax

(252) 407-4950

NPI assigned

Jul 14, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Samuel Cormelius Mayo Sr., LRT/CTRS

Title

QP/Co-Owner

Phone

(252) 281-7717

Specialties & licenses 2

Addresses

Tax ID family

Mayo'S Loving Care2 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.

• Mayo'S Loving Care

  • PACE Provider Organization
  • Rocky Mount, NC
  • NPI 1114246956
  NPD tax ID

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279065600000",
    "number": "1992018352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 KRISTA LN",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278035228",
            "telephone_number": "252-973-8593",
            "fax_number": "252-407-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 KRISTA LN",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278035228",
            "telephone_number": "252-973-8593",
            "fax_number": "252-407-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYOS LOVING CARE ADULT GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-14",
        "last_updated": "2010-07-14",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "CORMELIUS",
        "authorized_official_title_or_position": "QP/CO-OWNER",
        "authorized_official_telephone_number": "252-281-7717",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "LRT/CTRS"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "MHL064115",
            "primary": true
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "NC",
            "license": "MHL064115",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary B Home Care
• Gordon L Mathes, MD
• Harry Marquette Matthews, P.A.
• William Joseph Mayo, PA-C
• Mayo'S Loving Care
• Amanda Mboumien
• Kelly Whitson McAlarney, M.D.
• John Edward McAuliffe, M.D.
• Greig Vincent McAvoy, MD
• Louisa R McBeth, LCSW

• In Home Supportive Care Agency in Rocky Mount, NC
• Providers in Rocky Mount, 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 Jul 14, 2010; 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.