NPIMap

Organization Active NPI

County of Caswell

  • State or Local Public Health Clinic/Center
  • Yanceyville, NC
National Provider Identifier
1003949306
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
COUNTY OF CASWELL
Doing business as
Caswell Cnty Health Dept Flu and Pneumonia
Practice address
189 County Park Rd.
Yanceyville, NC 27379
Phone
(336) 694-4129
Fax
(336) 694-7030
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Authorized official

Name
Frederick Moore
Title
Health Director
Phone
(336) 694-4129

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
State or Local Public Health Clinic/Center 261QP0905X Primary

Addresses

Primary practice location

189 County Park Rd.
Yanceyville, NC 27379

Mailing address

PO Box 1238
Yanceyville, NC 27379-1238
Phone (336) 694-4129

Other names 1

  • Caswell Cnty Health Dept Flu and Pneumonia Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080924000402 NC Part B Supplier - Clinic/Group Practice 1052334372 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Yanceyville, NC
O20090508000342 NC Part B Supplier - Mass Immunization (Roster Biller Only) 1052334372 Practice locations: Yanceyville, NC

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1003949306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1238",
            "city": "YANCEYVILLE",
            "state": "NC",
            "postal_code": "273791238",
            "telephone_number": "336-694-4129",
            "fax_number": "336-694-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 COUNTY PARK RD.",
            "city": "YANCEYVILLE",
            "state": "NC",
            "postal_code": "27379",
            "telephone_number": "336-694-4129",
            "fax_number": "336-694-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF CASWELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "336-694-4129"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Caswell Cnty Health Dept Flu and Pneumonia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yanceyville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.