NPIMap

Organization Active NPI

Easter Seals Ucp North Carolina & Virginia, Inc.

  • Community/Behavioral Health Agency
  • Raleigh, NC
National Provider Identifier
1114094448
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Practice address
5171 Glenwood Ave
Suite 400
Raleigh, NC 27612
Phone
(919) 783-8898
Fax
(919) 782-5486
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Authorized official

Name
Nasheba Key-Allred
Title
Credentialing Specialist
Phone
(919) 865-8632

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NC
Developmentally Disabled Services Day Training Agency 251C00000X NC
Community/Behavioral Health Agency 251S00000X NC Primary

Addresses

Primary practice location

5171 Glenwood Ave
Suite 400
Raleigh, NC 27612

Mailing address

5171 Glenwood Ave
Suite 400
Raleigh, NC 27612-3266
Phone (919) 783-8898

Other practice location 1

3405 W Wendover Ave Ste H
Greensboro, NC 27407-1525
Phone (919) 783-8898

Other practice location 2

3405 W Wendover Ave Ste C
Greensboro, NC 27407-1525
Phone (919) 783-8898

Other practice location 3

4293 Highway 24 27 E Ste A
Midland, NC 28107-8500
Phone (919) 783-8898

Other practice location 4

2574 Southmont Dr
Asheboro, NC 27205-0953
Phone (919) 783-8898

Other practice location 5

620 W Innes St
Salisbury, NC 28144-4143
Phone (704) 647-0256

Other practice location 6

1100 S Stratford Rd Ste 303
Winston Salem, NC 27103-3217
Phone (919) 783-8898

Other identifiers 1

IdentifierTypeStateIssuer
3408598MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101105000534 NC Part B Supplier - Clinic/Group Practice 7618161407 Receives reassigned benefits from 79 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Raleigh, NC; Jacksonville, NC; New Bern, NC; Nags Head, NC; Mount Airy, NC; Morganton, NC; Morehead City, NC; Kinston, NC…

National Provider Directory

National Provider Directory
Tax ID family
Easter Seals Ucp North Carolina Virginia Inc224 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

4293 Highway 24 27 E
Ste A
Midland, NC 28107

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633651200000",
    "number": "1114094448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 GLENWOOD AVE",
            "address_2": "SUITE 400",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123266",
            "telephone_number": "919-783-8898",
            "fax_number": "919-782-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5171 GLENWOOD AVE",
            "address_2": "SUITE 400",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27612",
            "telephone_number": "919-783-8898",
            "fax_number": "919-782-5486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3405 W Wendover Ave Ste H",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274071525",
            "country_code": "US",
            "telephone_number": "919-783-8898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3405 W Wendover Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274071525",
            "country_code": "US",
            "telephone_number": "919-783-8898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4293 Highway 24 27 E Ste A",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "NC",
            "postal_code": "281078500",
            "country_code": "US",
            "telephone_number": "919-783-8898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2574 Southmont Dr",
            "address_purpose": "LOCATION",
            "city": "Asheboro",
            "state": "NC",
            "postal_code": "272050953",
            "country_code": "US",
            "telephone_number": "919-783-8898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 W Innes St",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281444143",
            "country_code": "US",
            "telephone_number": "704-647-0256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 S Stratford Rd Ste 303",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033217",
            "country_code": "US",
            "telephone_number": "919-783-8898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A",
        "authorized_official_last_name": "KEY-ALLRED",
        "authorized_official_first_name": "NASHEBA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "919-865-8632"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408598",
            "state": "NC"
        }
    ],
    "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 Oct 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.