NPIMap

Organization Active NPI

Penslow Health Clinic Inc

Doing business as Penslow Medical Center

  • Rural Health Clinic/Center
  • Holly Ridge, NC
National Provider Identifier
1093813842
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PENSLOW HEALTH CLINIC INC
Doing business as
Penslow Medical Center
Practice address
206 N Dyson St
Holly Ridge, NC 28445
Phone
(910) 329-7591
Fax
(910) 329-1592
NPI assigned
Sep 20, 2006
Last updated
Apr 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Authorized official

Name
Mrs. Cheryl B Hines
Title
Office Manager
Phone
(910) 329-7591

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

206 N Dyson St
Holly Ridge, NC 28445

Mailing address

PO Box 159
Holly Ridge, NC 28445
Phone (910) 329-7591

Other identifiers 2

IdentifierTypeStateIssuer
313803CMedicaidNC
3438034AMedicaidNC

Other names 1

  • Penslow Medical Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

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": "1208304000000",
    "number": "1093813842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 159",
            "city": "HOLLY RIDGE",
            "state": "NC",
            "postal_code": "28445",
            "telephone_number": "910-329-7591",
            "fax_number": "910-329-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N DYSON ST",
            "city": "HOLLY RIDGE",
            "state": "NC",
            "postal_code": "28445",
            "telephone_number": "910-329-7591",
            "fax_number": "910-329-1592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENSLOW HEALTH CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "910-329-7591",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "313803C",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3438034A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penslow Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holly Ridge, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.