Organization Active NPI

North Raleigh Psychiatry, PA

  • Psychiatry Physician
  • Raleigh, NC
National Provider Identifier
1073610119
Registry record updated Feb 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
NORTH RALEIGH PSYCHIATRY, PA
Practice address
5530 Munford Rd
Suite 119
Raleigh, NC 27612-2638
Phone
(919) 782-9554
Fax
(919) 782-9130
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2014

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

Authorized official

Name
Jeffrey Louis Snow, M.D.NPI 1518064625
Title
President
Phone
(919) 782-9554

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

5530 Munford Rd
Suite 119
Raleigh, NC 27612-2638

Mailing address

5530 Munford Rd
Suite 119
Raleigh, NC 27612-2638
Phone (919) 782-9554

Other identifiers 2

IdentifierTypeStateIssuer
0144FOtherNCNC BLUE CROSSBLUE SHIELD
890144FMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060417000475 NC Part B Supplier - Clinic/Group Practice 5092724278 Receives reassigned benefits from 3 practitioners
Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory

Locations

5530 Munford Rd
Ste 119
Raleigh, NC 27612
Phone (919) 782-9554

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393372800000",
    "number": "1073610119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5530 MUNFORD RD",
            "address_2": "SUITE 119",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122638",
            "telephone_number": "919-782-9554",
            "fax_number": "919-782-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 MUNFORD RD",
            "address_2": "SUITE 119",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122638",
            "telephone_number": "919-782-9554",
            "fax_number": "919-782-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH RALEIGH PSYCHIATRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-02-26",
        "status": "A",
        "authorized_official_last_name": "SNOW",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-782-9554",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BLUE CROSSBLUE SHIELD",
            "identifier": "0144F",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890144F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.