NPIMap

Organization Active NPI

Community Innovations, Inc.

  • Psychiatry Physician
  • Lumberton, NC
National Provider Identifier
1013047836
Registry record updated Apr 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
COMMUNITY INNOVATIONS, INC.
Practice address
2003 Godwin Ave
Suite a
Lumberton, NC 28358-3197
Phone
(910) 739-8849
Fax
(910) 739-5167
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2009

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

Authorized official

Name
Mr. Andy Anderson
Title
President Ceo
Phone
(910) 739-8849

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X NC Primary

Addresses

Primary practice location

2003 Godwin Ave
Suite a
Lumberton, NC 28358-3197

Mailing address

3210 Fairhill Dr
Raleigh, NC 27612-3215
Phone (919) 256-0824

Other identifiers 1

IdentifierTypeStateIssuer
5903155MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Community Innovations48 organizations share this tax ID, including this one

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240963200000",
    "number": "1013047836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 FAIRHILL DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123215",
            "telephone_number": "919-256-0824",
            "fax_number": "919-256-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 GODWIN AVE",
            "address_2": "SUITE A",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583197",
            "telephone_number": "910-739-8849",
            "fax_number": "910-739-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY INNOVATIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2009-04-29",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "910-739-8849",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903155",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; 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.