=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104736362
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TONY BARNES
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/10/2026
-----------------------------------------------------
Last Update Date | 09/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4201 S HATHAWAY BVLD STE C
-----------------------------------------------------
City | SHARPSBURG
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27878
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-969-3840
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1225 MCDUFFERS RD
-----------------------------------------------------
City | ROCKY MOUNT
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27804-9652
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-969-3840
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number | HC8386
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------