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GENESIS OF CAROLINAS HOME CARE, LLC
NPI 1295028710
Home Health in Charlotte, NC

Active since May 17, 2011CLIA 34D2133096 · Waiver
5736 NORTH TRYON STREET SUITE 128, CHARLOTTE, NC 28213(980) 207-3947(980) 207-3956 Get Directions Write a Review

NPPES record last updated: August 1, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Genesis Of Carolinas Home Care, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GENESIS OF CAROLINAS HOME CARE, LLC (NPI 1295028710) is a healthcare organization registered as a home health in Charlotte, North Carolina and active in the NPI registry since May 2011. The organization holds a CLIA Waiver certificate valid through July 5, 2027 and lists Octavia Devonne Shankle, Owner/director, as its authorized official.

NPPES Registry Identity

NPI1295028710
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameGENESIS OF CAROLINAS HOME CARE, LLC
Location Address5736 NORTH TRYON STREET SUITE 128Charlotte, NC 28213-6891
Mailing Address5736 North Tryon Street Suite 128Charlotte, NC 28213-6891 · (980) 207-3947 · Fax (980) 207-3956
Phone(980) 207-3947
Fax(980) 207-3956
Organization SubpartYes
Authorized OfficialOctavia Devonne ShankleOwner/director · (980) 207-3947
Enumeration DateMay 17, 2011
Last NPPES UpdateAugust 1, 2019
✔ NPI 1295028710 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
License✔ Licensed in NC · HC3994
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
5736 NORTH TRYON STREET SUITE 128, Charlotte, NC 28213
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Other Identifiers 1

Medicaid3418972NC

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2133096

Genesis Of Carolinas Home Care, LLC · Charlotte, NC
Active · expires Jul 5, 2027
CLIA Number34D2133096
Laboratory TypeHome Health Agency
Certificate Effective DateJuly 6, 2025
Certificate Expiration DateJuly 5, 2027
Laboratory DirectorPhyllis Caple
Laboratory Phone(980) 207-3947
Laboratory LocationGenesis Of Carolinas Home Care, LLC5736 North Tryon Street, Suite 128, Charlotte, NC 28213
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GENESIS OF CAROLINAS HOME CARE, LLC
Home Health
5736 NORTH TRYON STREET SUITE 128
CHARLOTTE, NC 28213
Mecklenburg County (980) 207-3947

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Genesis Of Carolinas Home Care, LLC's NPI number?

The NPI number for Genesis Of Carolinas Home Care, LLC is 1295028710. It was assigned to this organization in the NPPES registry on May 17, 2011.

Where is Genesis Of Carolinas Home Care, LLC located?

Genesis Of Carolinas Home Care, LLC is located at 5736 North Tryon Street Suite 128, Charlotte, NC 28213. The listed phone number is (980) 207-3947.

What is Genesis Of Carolinas Home Care, LLC's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Does Genesis Of Carolinas Home Care, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2133096) is associated with this NPI, valid through July 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Genesis Of Carolinas Home Care, LLC was last updated on August 1, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.