STATE OF NC DIVISION OF HEALTH SERVICES (NPI# 1841414257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841414257 |
| Entity Type | Organization |
| Organization Name | STATE OF NC DIVISION OF HEALTH SERVICES |
| Practice Address |
1211a Ireland Dr Fayetteville NC 28304-3372 |
| Mailing Address |
Dph- Early Intervention Br 1916 Mail Service Center Raleigh NC 27699-1916 |
| Practice Telephone | 9194861605 |
| Practice Fax Number | 9194861590 |
| Mailing Telephone | 9197075520 |
| Mailing Fax Number | 9198704834 |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2012-04-27 |
| Authorized Official Name | DR. DEBORAH E. CARROLLD (EARLY INTERVENTION BRANCH HEAD) |
| Authorized Official Telephone | 9197075520 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3403412 | 05 | |
| NC | BLUE CROSS BLUE SHIELD | 13409 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114143542 | State of Nc Division of Health Services | Clinic/Center | 145 West Parker Road, Suite A, Morganton, NC 28655-4649 | 2007-04-17 |
| 1558587972 | State of Nc Division of Health Services | Clinic/Center | 87 Bonnie Lane, Sylva, NC 28779-8511 | 2007-04-17 |
| 1063637411 | State of Nc Division of Health Services | Clinic/Center | 3311 Burnt Mill Dr, Suite 100, Wilmington, NC 28403-2654 | 2007-04-13 |
| 1891919254 | State of Nc Division of Health Services | Clinic/Center | 2359 Highway 105, Boone, NC 28607-7814 | 2007-04-13 |
| 1104041540 | State of Nc Division of Health Services | Clinic/Center | 141 Storage Rd, Rocky Mount, NC 27804-8561 | 2007-04-13 |
| 1801011242 | State of Nc Division of Health Services | Clinic/Center | 10 Parker Ln, Suite 1, Pinehurst, NC 28374-7903 | 2007-04-13 |
| 1942424387 | State of Nc Division of Health Services | Clinic/Center | 852 Merrimon Ave, Asheville, NC 28804-2405 | 2007-04-13 |
| 1346464716 | State of Nc Division of Health Services | Clinic/Center | 1065 Vinehaven Dr, Concord, NC 28025-2439 | 2007-04-13 |
| 1568686988 | State of Nc Division of Health Services | Clinic/Center | 122 N Elm St, Suite 400, Greensboro, NC 27401-2842 | 2007-04-13 |
| 1801011234 | State of Nc Division of Health Services | Clinic/Center | 2842 Neuse Blvd, New Bern, NC 28562-2839 | 2007-04-13 |
| Street Address |
1211A IRELAND DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-3372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790818847 | Marjory A Cannon | Physical Therapist | 1211a Ireland Dr, Fayetteville, NC 28304-3372 | 2007-03-14 |
| 1912315151 | Betty Bradshaw | Nurse Practitioner | 1211a Ireland Dr, Fayetteville, NC 28304-3372 | 2014-07-31 |
| 1417244534 | Helen D Conaty | Speech-Language Pathologist | 1211a Ireland Dr, Fayetteville, NC 28304-3372 | 2011-07-10 |
| 1407052574 | Amanda M Shultz | Occupational Therapist | 1211a Ireland Dr, Fayetteville, NC 28304-3372 | 2007-06-25 |
| 1518082759 | Lisa Renee Hemstreet | Psychologist | 1211a Ireland Dr, Fayetteville, NC 28304-3372 | 2007-03-20 |
| 1154454239 | Judith Lynn Pittard | Speech-Language Pathologist | 1211a Ireland Dr, Fayetteville, NC 28304-3372 | 2007-03-14 |
| 1356474431 | Cynthia Janelle Carter | Speech-Language Pathologist | 1211a Ireland Dr, Fayetteville, NC 28304-3372 | 2007-03-14 |
| 1144353210 | Kimberly Ann Webb | Social Worker | 1211a Ireland Dr, Fayetteville, NC 28304-3372 | 2007-03-14 |
| 1164555264 | Zelina A Henry | Physical Therapist | 1211a Ireland Dr, Fayetteville, NC 28304-3372 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871627919 | Professonal Family Care Services, Inc | Clinic/Center | 1012 Pamalee Dr, Fayetteville, NC 28303 | 2007-03-14 |
| 1346394814 | Taft's Creative Service Council, Inc. | Clinic/Center | 413 Country Club Dr, Fayetteville, NC 28301-7601 | 2007-01-22 |
| 1619337904 | Horse-play Pediatrics | Clinic/Center | 3801 Johnson Mill Blvd Ste B, Fayetteville, AR 72704-6364 | 2016-02-29 |
| 1942328695 | Jeans Rest Home | Clinic/Center | 114 University Ave, Fayetteville, NC 28301-3440 | 2007-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578174355 | A Better You Wellness Center | Clinic/Center | 3103 Durant Rd, Greenville, NC 27834-6786 | 2020-08-13 |
| 1770118556 | Enable LLC | Clinic/Center | 4050 Legion Rd, Hope Mills, NC 28348-8872 | 2020-03-11 |
| 1083128508 | Almarch Family Care, LLC | Clinic/Center | 1924 Beverly Rd, Rocky Mount, NC 27801-6313 | 2017-11-20 |
| 1669995577 | L.a.s Learning Playhouse, LLC | Clinic/Center | 210 Craver Ave, Salisbury, NC 28146-5906 | 2017-07-23 |
| 1528314408 | Laura Maria Mckoy | Clinic/Center | 122 Live Oak Drive, Jacksonville, NC 28540 | 2012-07-30 |
| 1306123294 | Lane's House Adult Group Home | Clinic/Center | 3159 Octavia Dr, Rocky Mount, NC 27804-7959 | 2011-11-07 |
| 1639408248 | Self-determination LLC | Clinic/Center | 103 Ebenezer Rd, Kings Mtn, NC 28086 | 2009-12-09 |
| 1235388133 | Eaglemere Living Facility | Clinic/Center | 200 Eagles Mere Trl, Rocky Mount, NC 27804-8850 | 2008-09-16 |
| 1043468796 | Making It Happen, Inc. | Clinic/Center | 355 Ransom Rd, Winston Salem, NC 27106-3835 | 2008-09-07 |
| 1689841298 | Safe Harbour | Clinic/Center | 13 East Dr, Jacksonville, NC 28546-8214 | 2008-05-13 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
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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.