NPIMap

Organization Active NPI

Peterkin and Associates, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Clinton, NC
National Provider Identifier
1124227277
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
PETERKIN AND ASSOCIATES, INC.
Practice address
118 E. Elizabeth Street
Clinton, NC 28328-4018
Phone
(910) 590-2286
Fax
(910) 592-3217
NPI assigned
Jul 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Authorized official

Name
Mrs. Alice D. Smith, ED.D
Title
Executive Director
Phone
(910) 323-1817

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Mental Illness Community Based Residential Treatment Facility 320800000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary
Substance Abuse Rehabilitation Facility 324500000X
Children's Substance Abuse Rehabilitation Facility 3245S0500X

Addresses

Primary practice location

118 E. Elizabeth Street
Clinton, NC 28328-4018

Mailing address

131 Hay Street
Suite 201
Fayetteville, NC 28301-5649
Phone (910) 323-1817

Other identifiers 5

IdentifierTypeStateIssuer
8302100AMedicaidNC
8302100PMedicaidNC
8302100QMedicaidNC
8302100MedicaidNC
8302100BMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Peterkin Associates Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257811200000",
    "number": "1124227277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 HAY STREET",
            "address_2": "SUITE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015649",
            "telephone_number": "910-323-1817",
            "fax_number": "910-323-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E. ELIZABETH STREET",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283284018",
            "telephone_number": "910-590-2286",
            "fax_number": "910-592-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERKIN AND ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2009-11-10",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "910-323-1817",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ED.D"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302100A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302100P",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302100Q",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302100",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302100B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.