Active NPI
Marion E. Wall
- Adult Day Care Clinic/Center
- Fayetteville, NC
National Provider Identifier
1114106077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Day Care Clinic/Center
- Legal business name
- MARION E. WALL
- Doing business as
- Cape Fear Adult Day Health Care Center
- Practice address
- 920 Stamper Rd
Fayetteville, NC 28303-4138 - Phone
- (910) 323-4424
- Fax
- (910) 323-3622
- NPI assigned
- Oct 29, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marion Elizabeth Wall
- Title
- Director/Owner
- Phone
- (910) 323-4424
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | Primary |
Addresses
Primary practice location
920 Stamper Rd
Fayetteville, NC 28303-4138
Mailing address
920 Stamper Rd
Fayetteville, NC 28303-4138
Phone (910) 323-4424
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3408729 | Medicaid | NC |
Other names 1
- Cape Fear Adult Day Health Care Center
National Provider Directory
National Provider DirectoryLocations
920 Stamper Rd
Fayetteville, NC 28303
Phone (910) 323-4424
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193616000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214265600000",
"number": "1114106077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 STAMPER RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283034138",
"telephone_number": "910-323-4424",
"fax_number": "910-323-3622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 STAMPER RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283034138",
"telephone_number": "910-323-4424",
"fax_number": "910-323-3622"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARION E. WALL",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-29",
"last_updated": "2008-06-24",
"status": "A",
"authorized_official_last_name": "WALL",
"authorized_official_first_name": "MARION",
"authorized_official_middle_name": "ELIZABETH",
"authorized_official_title_or_position": "DIRECTOR/OWNER",
"authorized_official_telephone_number": "910-323-4424"
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3408729",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Cape Fear Adult Day Health Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.