DEREK'S PLACE (NPI# 1033651070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033651070 |
| Entity Type | Organization |
| Organization Name | DEREK'S PLACE |
| Practice Address |
150 Secret Garden Ln Apt 1 Winston Salem NC 27104-4721 |
| Practice Telephone | 3366713046 |
| Mailing Telephone | 3366713046 |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2016-11-08 |
| Authorized Official Name | MR. ERIC HAIRSTON (EXECUTIVE ADMINISTRATOR) |
| Authorized Official Telephone | 3366713046 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| N | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Respite Care Facility | ||
| Y | 251E00000X | Home Health | Agencies |
| Street Address |
150 SECRET GARDEN LN APT 1 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27104-4721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447807664 | Cameron Grant Ford | Psychologist | 614 Country Club Road, Winston-salem, NC 27104 | 2019-08-22 |
| 1104310374 | Novant Medical Group, Inc. | Internal Medicine | 4937 Old Country Club Rd, Winston Salem, NC 27104 | 2018-06-20 |
| 1982100509 | Dillon James Magalski | Student in an Organized Health Care Education/Training Program | Piedmont Plaza 1, 1920 West First Street, Wake Forest Baptist Medical Center, Winston-salem, NC 27104 | 2018-04-03 |
| 1891290144 | Breann M Poling | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center, Department Of, Family Medicine Piedmont Plaza I 1920 West First Street, Winston Salem, NC 27104 | 2018-03-28 |
| 1689178600 | Christopher Vasil | Student in an Organized Health Care Education/Training Program | Piedmont Plaza I, 1920 West First Street, Department of Family Medicine, Winston Salem, NC 27104 | 2018-03-23 |
| 1407379126 | April Lynn Lowe | Registered Nurse | 940 N Peace Haven Rd, Winstonsalem, NC 27104 | 2017-07-25 |
| 1164950804 | Donald Joyce | Student in an Organized Health Care Education/Training Program | 1920 West First St, Piedmont Plaza I Building, 3rd Floor, Winston-salem, NC 27104 | 2017-05-25 |
| 1255867289 | Benjamin Hansen | Pharmacist | 2150 Country Club Rd Ste 300, Winston Salem, NC 27104 | 2017-05-11 |
| 1770020976 | Jane Reed | Physical Medicine & Rehabilitation | 2627 E Greenbrier Road, Winston Salem, NC 27104 | 2017-01-25 |
| 1053728261 | Ashraf Alsaedi | Pharmacist | 1659 Stratford Rd Nw, Winston Salem, NC 27104 | 2014-07-20 |
| Find all providers in zip 27104 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| 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. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376140723 | A Lending Hand Home Care Services LLC | Home Health | 1922 S Mlk Jr Dr Ste 203, Winston Salem, NC 27107-1361 | 2020-10-07 |
| 1104442177 | Reco Wilson | Home Health | 5270 Germanton Rd, Winston Salem, NC 27105-1616 | 2020-06-24 |
| 1629692710 | Provision Home Care Agency, LLC | Home Health | 3516 Vest Mill Rd Ste A, Winston Salem, NC 27103-3070 | 2020-06-03 |
| 1386267888 | Nurses Station Home Care LLC | Home Health | 246 Everidge Rd, Winston Salem, NC 27103-6308 | 2020-05-19 |
| 1831719228 | Piedmont Premium Care,llc | Home Health | 500 W 4th St Ste 201f, Winston Salem, NC 27101-2782 | 2020-04-26 |
| 1891330130 | Goodworks Health Management, LLC | Home Health | 3425 S Main St, Winston Salem, NC 27127-5127 | 2019-11-11 |
| 1245873504 | Stay At Home Health Care | Home Health | 1122 E 17th St, Winston Salem, NC 27105-6178 | 2019-10-18 |
| 1225682016 | Olufemi Samuel Akinade | Home Health | 120 Cloverfield Ct, Winston Salem, NC 27127-9756 | 2019-07-30 |
| 1194378067 | Maria A Hickman | Home Health | 1660 Marble St, Winston Salem, NC 27107-1415 | 2019-07-19 |
| 1417422478 | Bumblebee Services | Home Health | 3060 Apollo Dr, Winston Salem, NC 27101-1951 | 2018-10-05 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27104 |
Please comment or provide details below to improve the information on DEREK'S PLACE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.