NPIMap

Organization Active NPI

Robeson Health Care Corporation

  • Community/Behavioral Health Agency
  • Smithfield, NC
National Provider Identifier
1023150968
Registry record updated Jun 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL-051-139 Issued in NC
Legal business name
ROBESON HEALTH CARE CORPORATION
Practice address
109 Cambridge PL
Smithfield, NC 27577-4717
Phone
(919) 989-8114
Fax
(919) 938-0503
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2017

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

Authorized official

Name
Mr. Tim Hall, MDIV
Title
Director of Behavioral Health SVCS
Phone
(910) 521-2900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X MHL-051-139 NC
Community/Behavioral Health Agency 251S00000X MHL-051-139 NC Primary

Addresses

Primary practice location

109 Cambridge PL
Smithfield, NC 27577-4717

Mailing address

60 Commerce Plaza Cir
Pembroke, NC 28372-7386
Phone (910) 521-2900

Other identifiers 5

IdentifierTypeStateIssuer
8300616PMedicaidNC
8300616MedicaidNC
8300616BMedicaidNC
8300616GMedicaidNC
6005788MedicaidNC

Other names 1

  • Cambridge Place Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031231000292 NC Part B Supplier - Clinic/Group Practice 1850290693 Receives reassigned benefits from 27 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Red Springs, NC; Smithfield, NC; Saint Pauls, NC; Pembroke, NC; Maxton, NC; Lumberton, NC; Fairmont, NC; Laurinburg, NC…

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498608000000",
    "number": "1023150968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 COMMERCE PLAZA CIR",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283727386",
            "telephone_number": "910-521-2900",
            "fax_number": "910-775-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CAMBRIDGE PL",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774717",
            "telephone_number": "919-989-8114",
            "fax_number": "919-938-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBESON HEALTH CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2017-06-28",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "DIRECTOR OF BEHAVIORAL HEALTH SVCS",
        "authorized_official_telephone_number": "910-521-2900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MDIV"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "MHL-051-139",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-051-139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300616P",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300616",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300616B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300616G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005788",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cambridge Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smithfield, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2017; 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.