NPIMap

Organization Active NPI

Supplemental Healthcare Staffing

  • Nursing Care Agency
  • Raleigh, NC
National Provider Identifier
1124302906
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
A-3203 Issued in NC
Legal business name
SUPPLEMENTAL HEALTHCARE STAFFING
Practice address
2626 Glenwood Ave
Suite160
Raleigh, NC 27608-1043
Phone
(919) 781-9565
Fax
(919) 781-9564
NPI assigned
Sep 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Authorized official

Name
Athena Wilson
Title
Respiratory Thearpist
Phone
(919) 698-9253

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X A-3203 NC Primary

Addresses

Primary practice location

2626 Glenwood Ave
Suite160
Raleigh, NC 27608-1043

Mailing address

612 Cecil St
Durham, NC 27707-3232

National Provider Directory

National Provider Directory
Tax ID family
Supplemental42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1124302906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 CECIL ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 GLENWOOD AVE",
            "address_2": "SUITE160",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276081043",
            "telephone_number": "919-781-9565",
            "fax_number": "919-781-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPLEMENTAL HEALTHCARE STAFFING",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-28",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ATHENA",
        "authorized_official_title_or_position": "RESPIRATORY THEARPIST",
        "authorized_official_telephone_number": "919-698-9253"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NC",
            "license": "A-3203",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 28, 2011; 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.