Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 251E00000X | Home Health | | HC0319 | NORTH CAROLINA | No |
| 2 | 251E00000X | Home Health | | HC0323 | NORTH CAROLINA | No |
| 3 | 291U00000X | Clinical Medical Laboratory | | 34D0882412 | NORTH CAROLINA | No |
| 4 | 251E00000X | Home Health | | HC0317 | NORTH CAROLINA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 347100A | MEDICARE ID-TYPE UNSPECIFIED | | |
| 2 | 347100 | MEDICARE UPIN | | |
| 3 | 3407100 | MEDICAID | NORTH CAROLINA | |
| 4 | =========002 | OTHER | | TRI CARE |
| 5 | 720273N | MEDICAID | NORTH CAROLINA | |
| 6 | ========= | OTHER | | ALL OTHER INSURANCES |
| 7 | 00789 | OTHER | NORTH CAROLINA | NC BLUE CROSS BLUE SHIELD |
| 8 | =========005 | OTHER | | TRI CARE |
| 9 | =========004 | OTHER | | TRI CARE |
| 10 | =========006 | OTHER | | TRI CARE |
| 11 | 347100B | MEDICARE ID-TYPE UNSPECIFIED | | |
| 12 | 347100C | MEDICARE ID-TYPE UNSPECIFIED | | |
