Genesishouse, Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

GENESISHOUSE, INC.

Practice address

549 Cox Rd
Suite a
Gastonia, NC 28054-0628

Phone

(704) 852-3778

Fax

(704) 853-8751

NPI assigned

Aug 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kelvin Fernandez Hall

Title

President

Phone

(704) 852-3778

Specialties & licenses 2

Addresses

Other identifiers 8

Practitioners 1

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

• Gloria Penny Plyler, MSW, LCSW

  • Clinical Social Worker
  • Dallas, NC
  • NPI 1063693174
  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309305600000",
    "number": "1093727893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551389",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280551389",
            "telephone_number": "704-852-3778",
            "fax_number": "704-853-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 COX RD",
            "address_2": "SUITE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280540628",
            "telephone_number": "704-852-3778",
            "fax_number": "704-853-8751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESISHOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2011-06-29",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "KELVIN",
        "authorized_official_middle_name": "FERNANDEZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-852-3778",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NC",
            "license": "9401389",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300892",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300892B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418147",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102216",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8303041R",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8303041",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300892V",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300892G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberley Gayhart
• Taylor Gazdeck
• Bolanle Mariam Gbadamosi, M.D
• Meghan Lauren Gearhart, DPT
• Genesis House, Inc.
• Genoa Healthcare LLC
• Melanie Gentile
• Genuwine Personal Care, LLC
• Jensen Roger George, MD
• Jenette G Gerst, PMHNP-BC

• Case Management Agency in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Case Management Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; 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.