ABLAKE HEALTHCARE LLC — NPI 1356189302 (Licensed & Credentialed In Home Supportive Care in COLUMBIA, SC)

CMS-1500 Box 24J / 33a • NPI

1356189302

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

253Z00000X

Licensed & Credentialed In Home Supportive Care

Box 32 Service Location & ZIP+4

1040 WILDWOOD CENTRE DR STE A, COLUMBIA, SC, 29229-8402

✓ 9-Digit EDI 837 ZIP+4 (29229-8402)

Practice Phone & Referral Fax

(843) 517-2809

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1356189302 (ABLAKE HEALTHCARE LLC) 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	`1356189302` (NPI-2 Organization / Facility)
Provider / Legal Name	ABLAKE HEALTHCARE LLC
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	1040 WILDWOOD CENTRE DR STE A, COLUMBIA, SC, 29229-8402
Practice Telephone / Fax	Tel: (843) 517-2809
Administrative Mailing Address	1040 WILDWOOD CENTRE DR STE A, COLUMBIA, SC, 29229-8402
Enumeration & Last Sync	Enumerated: 2024-07-16 \| CMS Record Updated: 2025-05-09
Authorized Official	KELSIE BLAKENEY (Chief Executive Officer)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1040 WILDWOOD CENTRE DR STE A, COLUMBIA, SC, 29229-8402

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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 (ABLAKE HEALTHCARE LLC)

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
`174200000X` — Meals Plain English: Licensed & Credentialed Meals	State: N/A \| License: `Verified` \| Primary: Secondary
`251E00000X` — Home Health Plain English: CMS-Certified Home Health Care & Skilled Nursing Agency	State: N/A \| License: `Verified` \| Primary: Secondary
`251F00000X` — Home Infusion Plain English: Licensed & Credentialed Home Infusion	State: N/A \| License: `Verified` \| Primary: Secondary
`251G00000X` — Hospice Care, Community Based Plain English: Licensed & Credentialed Agencies — Hospice Care, Community Based	State: N/A \| License: `Verified` \| Primary: Secondary
`251J00000X` — Nursing Care Plain English: Licensed Skilled Nursing & Inpatient Post-Acute Rehabilitation Facility (SNF)	State: N/A \| License: `Verified` \| Primary: Secondary
`261QA0600X` — Clinic/Center, Adult Day Care Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Secondary
`332B00000X` — Durable Medical Equipment & Medical Supplies Plain English: Licensed & Credentialed Suppliers — Durable Medical Equipment & Medical Supplies	State: N/A \| License: `Verified` \| Primary: Secondary
`332BN1400X` — Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies Plain English: Licensed & Credentialed Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies	State: N/A \| License: `Verified` \| Primary: Secondary
`332BP3500X` — Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition Plain English: Licensed & Credentialed Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition	State: N/A \| License: `Verified` \| Primary: Secondary
`332BX2000X` — Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies Plain English: Licensed & Credentialed Suppliers — Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	State: N/A \| License: `Verified` \| Primary: Secondary
`343900000X` — Non-emergency Medical Transport (VAN) Plain English: Licensed & Credentialed Non-emergency Medical Transport (VAN)	State: N/A \| License: `Verified` \| Primary: Secondary
`385H00000X` — Respite Care Plain English: Licensed & Credentialed Respite Care	State: N/A \| License: `Verified` \| Primary: Secondary
`253Z00000X` — In Home Supportive Care Plain English: Licensed & Credentialed In Home Supportive Care	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

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ABLAKE HEALTHCARE LLC (NPI #1356189302)