NPIMap

Organization Active NPI

Edwards Group Home

  • Mental Illness Community Based Residential Treatment Facility
  • Snow Hill, NC
National Provider Identifier
1124158746
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
MHL040015 Issued in NC
Legal business name
EDWARDS GROUP HOME
Practice address
306 W Greene St
Snow Hill, NC 28580-1436
Phone
(252) 747-4000
Fax
(252) 747-2602
NPI assigned
Mar 6, 2007
Last updated
Jan 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Authorized official

Name
Thomas McCollumNPI 1972633691
Title
Ceo
Phone
(252) 747-4000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X MHL040015 NC Primary

Addresses

Primary practice location

306 W Greene St
Snow Hill, NC 28580-1436

Mailing address

PO Box 295
Snow Hill, NC 28580-0295
Phone (252) 747-4000

Other identifiers 1

IdentifierTypeStateIssuer
7804026OtherNCPROVIDER NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Edwards Group Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1124158746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 295",
            "city": "SNOW HILL",
            "state": "NC",
            "postal_code": "285800295",
            "telephone_number": "252-747-4000",
            "fax_number": "252-747-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W GREENE ST",
            "city": "SNOW HILL",
            "state": "NC",
            "postal_code": "285801436",
            "telephone_number": "252-747-4000",
            "fax_number": "252-747-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARDS GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "MCCOLLUM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "252-747-4000"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL040015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "7804026",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snow Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.

Verify at the official NPI Registry.