NPIMap

Organization Active NPI

Oberry Neuro-Medical Treatment Center

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Goldsboro, NC
National Provider Identifier
1063558591
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
OBERRY NEURO-MEDICAL TREATMENT CENTER
Practice address
400 Old Smithfield Road
Goldsboro, NC 27530
Phone
(919) 851-4000
Fax
(919) 851-4038
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Karen Burkes
Title
Division Director
Phone
(919) 855-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

400 Old Smithfield Road
Goldsboro, NC 27530

Mailing address

400 Old Smithfield Road
Goldsboro, NC 27530-8464
Phone (919) 851-4000

Other identifiers 1

IdentifierTypeStateIssuer
3408028MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
O'Berry Neuro-Medical Treatment Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1063558591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 OLD SMITHFIELD ROAD",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275308464",
            "telephone_number": "919-851-4000",
            "fax_number": "919-851-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 OLD SMITHFIELD ROAD",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "27530",
            "telephone_number": "919-851-4000",
            "fax_number": "919-851-4038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBERRY NEURO-MEDICAL TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "BURKES",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "DIVISION DIRECTOR",
        "authorized_official_telephone_number": "919-855-4700"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408028",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.