NPIMap

Organization Active NPI

Martin-Tyrrell-Washington District Health Department

  • Community Based Hospice Care Agency
  • Plymouth, NC
National Provider Identifier
1124010210
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HC0523 Issued in NC
Legal business name
MARTIN-TYRRELL-WASHINGTON DISTRICT HEALTH DEPARTMENT
Practice address
198 NC Highway 45 N
Plymouth, NC 27962-9232
Phone
(252) 791-3138
Fax
(252) 791-3158
NPI assigned
Aug 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Katherine Davis, RN
Title
Home Care Director
Phone
(252) 791-3152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HC0523 NC Primary

Addresses

Primary practice location

198 NC Highway 45 N
Plymouth, NC 27962-9232

Mailing address

198 NC Highway 45 N
Plymouth, NC 27962-9232
Phone (252) 791-3138

Other identifiers 2

IdentifierTypeStateIssuer
3401572MedicaidNC
0024AOtherNCBLUE CROSS BLUE SHIELD

Other names 1

  • Roanoke Home Care & Hospice Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124010210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 NC HIGHWAY 45 N",
            "city": "PLYMOUTH",
            "state": "NC",
            "postal_code": "279629232",
            "telephone_number": "252-791-3138",
            "fax_number": "252-791-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 NC HIGHWAY 45 N",
            "city": "PLYMOUTH",
            "state": "NC",
            "postal_code": "279629232",
            "telephone_number": "252-791-3138",
            "fax_number": "252-791-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN-TYRRELL-WASHINGTON DISTRICT HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "HOME CARE DIRECTOR",
        "authorized_official_telephone_number": "252-791-3152",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NC",
            "license": "HC0523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3401572",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0024A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roanoke Home Care & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plymouth, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.