Active NPI
Marion G Knight
- Mental Illness Community Based Residential Treatment Facility
- Farmville, NC
National Provider Identifier
1043088230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- Practice address
- 3547 S Barrett St
Farmville, NC 27828-1776 - Phone
- (919) 510-1166
- NPI assigned
- Dec 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 11
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | NC | ||
| Assisted Living Facility (Mental Illness) | 3104A0625X | NC | ||
| Adult Care Home Facility | 311ZA0620X | NC | ||
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | NC | ||
| Physical Disabilities Residential Treatment Facility | 320700000X | NC | ||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | NC | ||
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | NC | ||
| Psychiatric Residential Treatment Facility | 323P00000X | NC | ||
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X | NC | ||
| Child Physical Disabilities Respite Care | 385HR2065X | NC | ||
| Mental Illness Community Based Residential Treatment Facility | 320800000X | NC | Primary |
Addresses
Primary practice location
3547 S Barrett St
Farmville, NC 27828-1776
Mailing address
3547 S Barrett St
Farmville, NC 27828-1776
Phone (919) 510-1166
Other names 1
- Melvin Jermaine Edwards
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704672000000",
"number": "1043088230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3547 S BARRETT ST",
"city": "FARMVILLE",
"state": "NC",
"postal_code": "278281776",
"telephone_number": "919-510-1166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3547 S BARRETT ST",
"city": "FARMVILLE",
"state": "NC",
"postal_code": "278281776",
"telephone_number": "919-510-1166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNIGHT",
"first_name": "MARION",
"middle_name": "G",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-12-18",
"last_updated": "2024-01-08",
"certification_date": "2024-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "3104A0625X",
"taxonomy_group": "",
"desc": "Assisted Living Facility, Assisted Living, Mental Illness",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "320700000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Physical Disabilities",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "322D00000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Emotionally Disturbed Children",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "323P00000X",
"taxonomy_group": "",
"desc": "Psychiatric Residential Treatment Facility",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "385HR2065X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Physical Disabilities, Child",
"state": "NC",
"license": null,
"primary": false
},
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "NC",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MELVIN",
"last_name": "EDWARDS",
"middle_name": "JERMAINE",
"credential": "OWNER,PRESIDENT",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Farmville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.