Organization Active NPI

Peach Tree Family Care

  • Assisted Living Facility
  • Raleigh, NC
National Provider Identifier
1104366863
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
PEACH TREE FAMILY CARE
Practice address
502 Carolina Ave
Raleigh, NC 27606-1604
Phone
(919) 866-9722
Fax
(919) 803-1951
NPI assigned
Feb 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2017

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

Authorized official

Name
Latonia Raynor
Title
Home Health Aide
Phone
(919) 866-9722

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

502 Carolina Ave
Raleigh, NC 27606-1604

Mailing address

5164 Simmons Branch TRL
Raleigh, NC 27606-7606
Phone (919) 866-9722

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488240000000",
    "number": "1104366863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5164 SIMMONS BRANCH TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276067606",
            "telephone_number": "919-866-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 CAROLINA AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276061604",
            "telephone_number": "919-866-9722",
            "fax_number": "919-803-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH TREE FAMILY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-28",
        "last_updated": "2017-02-28",
        "status": "A",
        "authorized_official_last_name": "RAYNOR",
        "authorized_official_first_name": "LATONIA",
        "authorized_official_title_or_position": "HOME HEALTH AIDE",
        "authorized_official_telephone_number": "919-866-9722"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.