NPIMap

Organization Active NPI

Community Innovations Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Fair Bluff, NC
National Provider Identifier
1033294376
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
MHL024021 Issued in NC
Legal business name
COMMUNITY INNOVATIONS INC.
Practice address
353 Elm St
Fair Bluff, NC 28439-9594
Phone
(910) 649-6460
NPI assigned
Oct 26, 2006
Last updated
May 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Authorized official

Name
Mary Johns Benson
Title
Revenue Cycle Director
Phone
(704) 995-2131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X MHL024021 NC Primary

Addresses

Primary practice location

353 Elm St
Fair Bluff, NC 28439-9594

Mailing address

4000 Paramount Pkwy Ste 100
Morrisville, NC 27560-8484
Phone (047) 995-2131

Other identifiers 1

IdentifierTypeStateIssuer
340603JMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Community Innovationsinc48 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": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1033294376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 PARAMOUNT PKWY STE 100",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608484",
            "telephone_number": "047-995-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 ELM ST",
            "city": "FAIR BLUFF",
            "state": "NC",
            "postal_code": "284399594",
            "telephone_number": "910-649-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY INNOVATIONS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JOHNS",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "704-995-2131"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NC",
            "license": "MHL024021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340603J",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Bluff, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.