NPIMap

Organization Active NPI

Clay County

  • Case Management Agency
  • Hayesville, NC
National Provider Identifier
1013113646
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
CLAY COUNTY
Practice address
119 Courthouse Dr
Hayesville, NC 28904-4968
Phone
(828) 389-6301
Fax
(828) 389-6427
NPI assigned
Jun 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Authorized official

Name
Revonda Moss
Title
Administrator Officer
Phone
(828) 389-6301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

119 Courthouse Dr
Hayesville, NC 28904-4968

Mailing address

PO Box 147
Hayesville, NC 28904-0147
Phone (828) 389-6301

Other identifiers 1

IdentifierTypeStateIssuer
8700086OtherNCMEDICAID PROVIDER NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Clay Co Health Dept3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

55 Riverside Cir
Hayesville, NC 28904

119 Courthouse Dr
Hayesville, NC 28904
Phone (828) 389-6301

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1013113646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 147",
            "city": "HAYESVILLE",
            "state": "NC",
            "postal_code": "289040147",
            "telephone_number": "828-389-6301",
            "fax_number": "828-389-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 COURTHOUSE DR",
            "city": "HAYESVILLE",
            "state": "NC",
            "postal_code": "289044968",
            "telephone_number": "828-389-6301",
            "fax_number": "828-389-6427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "REVONDA",
        "authorized_official_title_or_position": "ADMINISTRATOR OFFICER",
        "authorized_official_telephone_number": "828-389-6301"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PROVIDER NUMBER",
            "identifier": "8700086",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.