AGELESS HEART HEALTHCARE, INC — NPI 1225343395 (Licensed & Credentialed In Home Supportive Care in ERWIN, NC)

CMS-1500 Box 24J / 33a • NPI

1225343395

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

253Z00000X

Licensed & Credentialed In Home Supportive Care

Box 32 Service Location & ZIP+4

708 S 13TH ST, ERWIN, NC, 28339-2634

✓ 9-Digit EDI 837 ZIP+4 (28339-2634)

Practice Phone & Referral Fax

(910) 292-0173

Fax: (910) 292-0174

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1225343395 (AGELESS HEART HEALTHCARE, INC) 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	`1225343395` (NPI-2 Organization / Facility)
Provider / Legal Name	AGELESS HEART HEALTHCARE, INC
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	708 S 13TH ST, ERWIN, NC, 28339-2634
Practice Telephone / Fax	Tel: (910) 292-0173 \| Fax: (910) 292-0174
Administrative Mailing Address	708 S 13TH ST, ERWIN, NC, 28339-2634
Enumeration & Last Sync	Enumerated: 2010-08-13 \| CMS Record Updated: 2013-06-14
Authorized Official	JOHNATHAUN LEE (president)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

708 S 13TH ST, ERWIN, NC, 28339-2634

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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 (AGELESS HEART HEALTHCARE, INC)

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
`3747P1801X` — Technician, Personal Care Attendant Plain English: Licensed & Credentialed Technician, Personal Care Attendant	State: NC \| License: `hc2965` \| Primary: Secondary
`253Z00000X` — In Home Supportive Care Plain English: Licensed & Credentialed In Home Supportive Care	State: NC \| License: `hc2965` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AGELESS HEART HEALTHCARE, INC (NPI #1225343395)