NPIMap

Organization Active NPI

NC DHHS Child and Family Well-Being

  • Early Intervention Provider Agency
  • Rocky Mount, NC
National Provider Identifier
1104041540
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
NC DHHS CHILD AND FAMILY WELL-BEING
Practice address
141 Storage Rd
Rocky Mount, NC 27804-8561
Phone
(252) 443-0318
Fax
(252) 443-5079
NPI assigned
Apr 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Authorized official

Name
Qiudi Wang
Title
Operations Manager
Phone
(919) 707-5527

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

141 Storage Rd
Rocky Mount, NC 27804-8561

Mailing address

DPH- Early Intervention BR
1916 Mail Service Center
Raleigh, NC 27699-1916
Phone (919) 707-5520

Other identifiers 1

IdentifierTypeStateIssuer
3403405MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
NC DHHS Child and Family Well-Being12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

141 Storage Rd
Rocky Mount, NC 27804
Phone (252) 316-4809

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1104041540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DPH- EARLY INTERVENTION BR",
            "address_2": "1916 MAIL SERVICE CENTER",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276991916",
            "telephone_number": "919-707-5520",
            "fax_number": "919-870-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 STORAGE RD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048561",
            "telephone_number": "252-443-0318",
            "fax_number": "252-443-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NC DHHS CHILD AND FAMILY WELL-BEING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "QIUDI",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "919-707-5527"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3403405",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.