NPIMap

Organization Active NPI

Footprints Carolina Inc

  • Case Management Agency
  • Forest City, NC
National Provider Identifier
1053588038
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
FOOTPRINTS CAROLINA INC
Practice address
138 Allendale Dr
Forest City, NC 28043-2874
Phone
(828) 248-9990
Fax
(828) 248-9770
NPI assigned
May 9, 2008
Last updated
May 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2008

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

Authorized official

Name
Ms. Mary C Brannon
Title
Billing Coordinator
Phone
(704) 524-2091

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

138 Allendale Dr
Forest City, NC 28043-2874

Mailing address

2020 Remount Rd
Gastonia, NC 28054-7476
Phone (704) 884-2500

Other identifiers 1

IdentifierTypeStateIssuer
36265MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Footprints Carolina Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

138 Allendale Dr
Forest City, NC 28043
Phone (828) 248-9990

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1053588038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 REMOUNT RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547476",
            "telephone_number": "704-884-2500",
            "fax_number": "704-524-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 ALLENDALE DR",
            "city": "FOREST CITY",
            "state": "NC",
            "postal_code": "280432874",
            "telephone_number": "828-248-9990",
            "fax_number": "828-248-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTPRINTS CAROLINA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-05-09",
        "status": "A",
        "authorized_official_last_name": "BRANNON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "704-524-2091",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36265",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.