Genesisdwiservices

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

GENESISDWISERVICES

Practice address

35 W Davie St
Raleigh, NC 27601-1732

Phone

(919) 321-6643

Fax

(919) 321-8930

NPI assigned

May 27, 2015

Last updated

May 27, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gregory Dockery, CSAC-I

Title

Operations Manager

Phone

(919) 321-6643

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432684800000",
    "number": "1043699739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 W DAVIE ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276011732",
            "telephone_number": "919-321-6643",
            "fax_number": "919-321-8930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 W DAVIE ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276011732",
            "telephone_number": "919-321-6643",
            "fax_number": "919-321-8930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESISDWISERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-27",
        "last_updated": "2015-05-27",
        "status": "A",
        "authorized_official_last_name": "DOCKERY",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "919-321-6643",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CSAC-I"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kevin Matthew Gentile, PA-C
• Anika Marie Gentry, LCSWA

• Community/Behavioral Health Agency in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; 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.