AVID HEALTH AT HOME NORTH CAROLINA — NPI 1043451321 (Licensed & Credentialed In Home Supportive Care in SUPPLY, NC)

CMS-1500 Box 24J / 33a • NPI

1043451321

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

253Z00000X

Licensed & Credentialed In Home Supportive Care

Box 32 Service Location & ZIP+4

58 PHYSICIANS DR NW STE 106, SUPPLY, NC, 28462-4216

✓ 9-Digit EDI 837 ZIP+4 (28462-4216)

Practice Phone & Referral Fax

(910) 640-1150

Fax: (910) 640-1162

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1043451321 (AVID HEALTH AT HOME NORTH CAROLINA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1043451321` (NPI-2 Organization / Facility)
Provider / Legal Name	AVID HEALTH AT HOME NORTH CAROLINA
Plain-English Specialty	Licensed & Credentialed In Home Supportive Care NUCC Code: `253Z00000X` (In Home Supportive Care)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	58 PHYSICIANS DR NW STE 106, SUPPLY, NC, 28462-4216
Practice Telephone / Fax	Tel: (910) 640-1150 \| Fax: (910) 640-1162
Administrative Mailing Address	1508 MILITARY CUTOFF RD STE 304, WILMINGTON, NC, 28403-5730
Enumeration & Last Sync	Enumerated: 2009-03-16 \| CMS Record Updated: 2024-11-07
Authorized Official	JENNIFER LENTZ (CEO)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

58 PHYSICIANS DR NW STE 106, SUPPLY, NC, 28462-4216

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Plain-English Taxonomy & CMS Crosswalk (253Z00000X)

What Does Taxonomy Code 253Z00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 253Z00000X translates to:
"Licensed & Credentialed In Home Supportive Care"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified In Home Supportive Care for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AVID HEALTH AT HOME NORTH CAROLINA)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`251E00000X` — Home Health Plain English: CMS-Certified Home Health Care & Skilled Nursing Agency	State: NC \| License: `HC0916` \| Primary: Secondary
`251J00000X` — Nursing Care Plain English: Licensed Skilled Nursing & Inpatient Post-Acute Rehabilitation Facility (SNF)	State: NC \| License: `HC0916` \| Primary: Secondary
`253Z00000X` — In Home Supportive Care Plain English: Licensed & Credentialed In Home Supportive Care	State: NC \| License: `HC0916` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AVID HEALTH AT HOME NORTH CAROLINA (NPI #1043451321)