Provider Demographics
NPI:1811513997
Name:RHODES, YNEKA TRAVON
Entity type:Individual
Prefix:
First Name:YNEKA
Middle Name:TRAVON
Last Name:RHODES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W FIRE TOWER RD STE G
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-8408
Mailing Address - Country:US
Mailing Address - Phone:252-227-4523
Mailing Address - Fax:252-253-6263
Practice Address - Street 1:108 W FIRE TOWER RD STE G
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-8408
Practice Address - Country:US
Practice Address - Phone:252-227-4523
Practice Address - Fax:252-253-6263
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC5601251S00000X, 253Z00000X
343900000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1851962237Medicaid
NC4589Medicaid