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AVID WELLNESS COUNSELING AND CONSULTING INC
Complete NPI Record 1215693445
Home Health in Concord, NC

NPI Status: Active since November 11, 2021

Contact Information

1000 COPPERFIELD BLVD NE STE 112B
CONCORD, NC
ZIP 28025
Phone: (704) 236-4067
Fax: (704) 445-4582

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider Business Mailing Address Fax Number
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Business Practice Location Address Fax Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Authorized Official Last Name
  22. Authorized Official First Name
  23. Authorized Official Title or Position
  24. Authorized Official Telephone Number
  25. Healthcare Provider Taxonomy Code 1
  26. Healthcare Provider Primary Taxonomy Switch 1
  27. Healthcare Provider Taxonomy Code 2
  28. Healthcare Provider Primary Taxonomy Switch 2
  29. Is Organization Subpart
  30. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1215693445. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1215693445
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 1000 COPPERFIELD BLVD NE STE 112
The middle name of the provider, if the provider is an individual.
Provider Business Mailing Address City Name: CONCORD
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Business Mailing Address State Name: NC
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Business Mailing Address Postal Code: 280252454
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address Country Code If outside U S : US
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address Telephone Number: 7042364067
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Fax Number: 7044454582
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider First Line Business Practice Location Address: 1000 COPPERFIELD BLVD NE STE 112B
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Practice Location Address City Name: CONCORD
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Practice Location Address State Name: NC
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider Business Practice Location Address Postal Code: 280252454
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address Country Code If outside U S : US
The city name in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 7042364067
The State code in the location of the provider being identified.
Provider Business Practice Location Address Fax Number: 7044454582
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Enumeration Date: 11/11/2021
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 11/11/2021
The date that a record was last updated or changed.
Authorized Official Last Name: MILLNER
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: VERA
The date the provider was assigned a unique identifier (assigned an NPI).
Authorized Official Title or Position: OWNER
The date that a record was last updated or changed.
Authorized Official Telephone Number: 7042364067
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 251S00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: N
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Healthcare Provider Taxonomy Code 2: 251E00000X
Healthcare Provider Primary Taxonomy Switch 2: Y
Is Organization Subpart: N
NPI Certification Date: 11/11/2021