Community DME, Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

COMMUNITY DME, INC

Practice address

2409 Murchison Rd
Fayetteville, NC 28301-3519

Phone

(910) 488-6118

Fax

(910) 488-6810

NPI assigned

Jun 21, 2017

Last updated

Oct 26, 2021By 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

Delvin McAllister

Title

Ceo

Phone

(910) 488-6118

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC3 enrollments

Enrollment records 3

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083134092. Details of each certification follow.

• CCN 341076 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 341076

Legal name

COMMUNITY HEALTH INTERVENTIONS AND SICKLE CELL AGENCY INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Sep 8, 2017

Last certification

Sep 8, 2017

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Apr 24, 1974 in NC

Enrollment address

102 W Southern Ave
Raeford, NC 28376-3218

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shelia Maria Black, DNP, NP-C

  • Nurse Practitioner
  • Fayetteville, NC
  • NPI 1467830687
  Medicare reassignment NPD
• Stephanie Oliver, NP-C

  • Nurse Practitioner
  • Red Springs, NC
  • NPI 1336504018
  Medicare reassignment NPD
• Crystal Michelle Rogers, DNP

  • Family Nurse Practitioner
  • Elizabethtown, NC
  • NPI 1417387036
  Medicare reassignment NPD
• Roger D Warren, MD

  • Family Medicine Physician
  • Fayetteville, NC
  • NPI 1134184757
  Medicare reassignment NPD
• Eddie Nelson Powell, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Raeford, NC
  • NPI 1659305928
  NPD (past)

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1083134092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 MURCHISON RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013519",
            "telephone_number": "910-488-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 MURCHISON RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013519",
            "telephone_number": "910-488-6118",
            "fax_number": "910-488-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "MCALLISTER",
        "authorized_official_first_name": "DELVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-488-6118"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Alternative Housing, Inc.
• Community Connections Healthcare Services, LLC
• Community Focused, LLC
• Community Health Interventions, Inc
• Community Helps Network
• Community Helps Network Fayetteville
• Community Residential Supportive Service Home Health Inc (CRSS Home Health Inc)

• General Practice Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• General Practice Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.