WOLFE & JACKSON FAMILY CARE HOME
NPI 1457476913
Custodial Care Facility - Adult Care Home in Winston Salem, NC

NPI Status: Active since March 20, 2007

Contact Information

744 EAST SPRAGUE STREET
WINSTON SALEM, NC
ZIP 27107
Phone: (336) 722-8354
Fax: (336) 722-8354

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  • Organization
  • Custodial Care Facility
  • Adult Care Home
  • CLIA Number: 34D2048616
  • CLIA Cert. Type: Other - GROUP HOME
  • CLIA Exp. Date: 10-18-2026

About WOLFE & JACKSON FAMILY CARE HOME

This page provides the complete NPI Profile along with additional information for Wolfe & Jackson Family Care Home, a provider established in Winston Salem, North Carolina operating as a Custodial Care Facility, focusing in adult care home . The healthcare provider is registered in the NPI registry with number 1457476913 assigned on March 2007. The practitioner's primary taxonomy code is 311ZA0620X with license number FCL034020 (NC). The provider is registered as an organization and their NPI record was last updated 17 years ago. The authorized official of this NPI record is Mrs. Zelma Jackson Wolfe (Adminstator)

NPI
1457476913
Provider Name
WOLFE & JACKSON FAMILY CARE HOME
Entity Type
Organization
Location Address
744 EAST SPRAGUE STREET WINSTON SALEM, NC 27107
Location Phone
(336) 722-8354
Location Fax
(336) 722-8354
Mailing Address
PO BOX 12002 WINSTON SALEM, NC 27117
Mailing Phone
(336) 722-8354
Mailing Fax
(336) 722-8354
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-20-2007
Last Update Date
07-11-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Custodial Care Facility Adult Care Home

Taxonomy Code
311ZA0620X
Type
Nursing & Custodial Care Facilities
License No.
FCL034020
License State
NC
Taxonomy Description
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. ZELMA JACKSON WOLFE

Authorized Official Title
ADMINSTATOR
Authorized Official Phone
(335) 722-8354

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
7802068OTHER (01)NCPROVIDER #
237701279AMEDICARE ID-TYPE UNSPECIFIED (04)NC 
237701279PMEDICAID (05)NC 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
34D2048616
Facility Type
Other - GROUP HOME
Certificate Effective Date
October 19, 2024
Certificate Expiration Date
October 18, 2026
Laboratory Director
ZELMA WOLFE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Wolfe & Jackson Family Care Home to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1457476913
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
24107871292
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 1 + 0 + 7 + 8 + 7 + 1 + 2 + 9 + 2 + 24 = 67
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 67 = 33

The NPI number 1457476913 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1457476913, enumerated in the NPI registry as an "organization" on March 20, 2007

The provider is located at 744 East Sprague Street Winston Salem, Nc 27107 and the phone number is (336) 722-8354

This medical organization specializes in Custodial Care Facility with taxonomy code 311ZA0620X with a focus in Adult Care Home

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 34D2048616 for a "other - group home" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on March 20, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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