NPIMap

Organization Active NPI

Carolina Family Health Centers, Inc

Doing business as Harvest Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Elm City, NC
National Provider Identifier
1093883852
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CAROLINA FAMILY HEALTH CENTERS, INC
Doing business as
Harvest Family Health Center
Practice address
8250 NC 58 S
Elm City, NC 27822-8079
Phone
(252) 443-7744
Fax
(252) 443-7611
NPI assigned
Dec 1, 2006
Last updated
Oct 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Authorized official

Name
Mrs. Laura OwensNPI 1750410809
Title
Ceo
Phone
(252) 293-0013

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

8250 NC 58 S
Elm City, NC 27822-8079

Mailing address

303 Green St E
Wilson, NC 27893-4105
Phone (252) 293-0013

Other identifiers 1

IdentifierTypeStateIssuer
344582AMedicaidNC

Other names 1

  • Harvest Family Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050915000563 NC Part B Supplier - Clinic/Group Practice 6800841107 Receives reassigned benefits from 32 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Elm City, NC; Tarboro, NC; Wilson, NC
O20101229000269 NC Part A Provider - Federally Qualified Health Center (FQHC) 6800841107 Practice locations: Elm City, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093883852. Details of each certification follow.

Federally qualified health center certification: CCN 341860

Legal name
CAROLINA FAMILY HEALTH CENTERS, INC.
Doing business as
HARVEST FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 2000
Last certification
Jul 1, 2000
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 8, 1993 in NC
Enrollment address
8250 NC 58 S
Elm City, NC 27822-8079
Related CCNs
341859

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0945947Harvest Family Health Center8250 South NC 58, Elm City, NC 27822Provider-performed microscopyFeb 12, 2028

National Provider Directory

National Provider Directory

Locations

8250 NC 58 S
Elm City, NC 27822
Phone (252) 443-7744

303 Green St E
Wilson, NC 27893
Phone (252) 243-9800

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Evelyn Pruden Individual Corporate Director Oct 25, 2010
Charles Taylor Individual Corporate Director Jun 1, 2013
Todd Anderson Individual Corporate Director Jun 1, 2019
Benny Boykin Individual Corporate Director Jun 1, 2022
Phillip Byrum Individual Corporate Director Jun 1, 2015
Laura Owens Individual Corporate DirectorCeo May 1, 2019
W-2 Managing EmployeeCeo May 1, 2019
John Keller Individual Corporate Director Jun 1, 2019
Delphine Lucas Individual Corporate Director Jun 1, 2019
Jerome Garner Individual Corporate Director Jun 1, 2007
Elisabed Serrano Individual Corporate Director Jun 1, 2013
Kimberly Lynn Terry Individual Corporate DirectorCfo Aug 1, 2019
W-2 Managing EmployeeCfo Aug 1, 2019
Michele Cherry Individual Corporate Director Jun 1, 2019
Robin Williams Individual Corporate Director Jun 1, 2022

Practitioners & affiliated clinicians

Practitioners 8

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": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1093883852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 GREEN ST E",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934105",
            "telephone_number": "252-293-0013",
            "fax_number": "252-243-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8250 NC 58 S",
            "city": "ELM CITY",
            "state": "NC",
            "postal_code": "278228079",
            "telephone_number": "252-443-7744",
            "fax_number": "252-443-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA FAMILY HEALTH CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "252-293-0013",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344582A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harvest Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Harvest Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elm City, NC

Sources for this page

Verify at the official NPI Registry.