Organization Active NPI

Custom Case Management

  • Case Management Agency
  • Winston Salem, NC
National Provider Identifier
1003852534
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
2007 Issued in NC
Legal business name
CUSTOM CASE MANAGEMENT
Practice address
112 S Spruce St
Winston Salem, NC 27101-3767
Phone
(336) 480-0023
Fax
(336) 768-7229
NPI assigned
Jun 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Marianne Rizzolo
Title
Director
Phone
(336) 480-0023

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 2007 NC Primary

Addresses

Primary practice location

112 S Spruce St
Winston Salem, NC 27101-3767

Mailing address

112 S Spruce St
Winston Salem, NC 27101-3767
Phone (336) 480-0023

Other identifiers 4

IdentifierTypeStateIssuer
8300346GMedicaidNC
8300346JMedicaidNC
8300346MedicaidNC
8300346BMedicaidNC

National Provider Directory

National Provider Directory

Locations

112 S Spruce St
Winston Salem, NC 27101
Phone (336) 724-0101

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003852534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S SPRUCE ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013767",
            "telephone_number": "336-480-0023",
            "fax_number": "336-768-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S SPRUCE ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013767",
            "telephone_number": "336-480-0023",
            "fax_number": "336-768-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM CASE MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIZZOLO",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-480-0023",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": "2007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300346G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300346J",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300346",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300346B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.