MEDICAID TRAVEL, INC. (NPI# 1528607207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528607207 |
| Entity Type | Organization |
| Organization Name | MEDICAID TRAVEL, INC. |
| Practice Address |
615 Saint George Square Ct Ste 300 Winston Salem NC 27103-1368 |
| Practice Telephone | 9197370734 |
| Practice Fax Number | 2162508369 |
| Mailing Telephone | 9197370734 |
| Mailing Fax Number | 2162508369 |
| Enumeration Date | 2019-12-30 |
| Last Update Date | 2020-06-25 |
| Authorized Official Name | MR. DYLAN MACK CARDEN (CEO) |
| Authorized Official Telephone | 9197370734 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174200000X | Meals | Other Service Providers | ||
| N | 343900000X | Non-emergency Medical Transport (VAN) | Transportation Services | ||
| Y | 177F00000X | Lodging | Other Service Providers |
| Street Address |
615 SAINT GEORGE SQUARE CT STE 300 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-1368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295759538 | Alisha Beth Benner | Internal Medicine | 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 | 2006-07-27 |
| 1265054779 | Bertille Kuisso Ponkam | Health Educator | 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 | 2020-05-07 |
| 1730710328 | Counseling With A Purpose, Pllc | Clinic/Center | 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 | 2020-01-31 |
| 1316578404 | Hines Family Services Inc | Case Management | 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 | 2020-01-28 |
| 1629608849 | Amc Health North Carolina Inc | Durable Medical Equipment & Medical Supplies | 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 | 2020-01-16 |
| 1285132514 | Merida Amarilis Valera | Counselor | 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103 | 2018-02-01 |
| 1568971083 | Gail Williams-booker | Nurse Practitioner | 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 | 2017-09-27 |
| 1255794855 | Cheri Taylor | Nurse Practitioner | 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 | 2016-03-31 |
| 1760894596 | Jordan Harrold | Social Worker | 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 | 2014-05-28 |
| 1003199928 | Felicia Patterson Washington | Nurse Practitioner | 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103 | 2011-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 177F00000X |
| Grouping | Other Service Providers |
| Classification | Lodging |
| A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831701903 | Another Chance: House of Refuge | Lodging | 1708 Chambers Dr Apt 15, Matthews, NC 28105-4782 | 2020-08-20 |
| 1003107277 | The Manor At Riverbrooke | Lodging | 3120 Tuckland Drive, Raleigh, NC 27610-5257 | 2011-04-22 |
| 1306161013 | Guiding Star Health Care Adult Group Home | Lodging | 2809 Huntington Ct, Rocky Mount, NC 27803-1641 | 2010-04-06 |
| 1285866319 | The Manor At Edgewater | Lodging | 1038 Stormy Ln, Raleigh, NC 27610-6074 | 2009-08-24 |
| 1528204286 | Kirk Matthew Ledoux | Lodging | 305 Causby Ln, Hendersonville, NC 28791-8721 | 2008-12-31 |
| 1114191921 | Carillon Assisted Living of Lincolnton, LLC | Lodging | 440 Salem Church Road, Lincolnton, NC 28092-8856 | 2008-04-14 |
| 1790966554 | The Manor At Coventry Creek | Lodging | 5124 Werribee Dr, Raleigh, NC 27616-5546 | 2007-11-21 |
| 1801081310 | Lee's Family Care Home | Lodging | 945 Vaiden Road, Louisburg, NC 27549-8096 | 2007-09-07 |
| 1467650036 | Pittman Family Care | Lodging | 47 Piney Haven Dr, Bakersville, NC 28705-0525 | 2007-07-05 |
| 1235334194 | Suzan Lynne Booker | Lodging | 1424 Huntdell Main Dr, Wendell, NC 27591-7254 | 2007-06-19 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
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| 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.