Group Service Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

GROUP SERVICE INC

Practice address

1503 Denim Dr
Suite 101
Erwin, NC 28339-3017

Phone

(919) 822-2172

NPI assigned

Oct 18, 2011

Organization subpart

No

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

Authorized official

Name

Antonio Fozard

Title

Ceo

Phone

(919) 697-6957

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Group Service Inc2 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.

• Group Service Inc

  • Community/Behavioral Health Agency
  • Durham, NC
  • NPI 1518256502
  NPD tax ID

Locations

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1144505504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12821",
            "city": "RTP",
            "state": "NC",
            "postal_code": "277092821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 DENIM DR",
            "address_2": "SUITE 101",
            "city": "ERWIN",
            "state": "NC",
            "postal_code": "283393017",
            "telephone_number": "919-822-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROUP SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-18",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "FOZARD",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-697-6957"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918588",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Erwin, NC
• Providers in Erwin, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.