Mt Jefferson Child Development Center

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

05000070 Issued in NC

Legal business name

MT JEFFERSON CHILD DEVELOPMENT CENTER

Practice address

123 Gentry St
Jefferson, NC 28640-9787

Phone

(338) 846-2208

Fax

(336) 846-2697

NPI assigned

May 25, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Becky Goss

Title

Center Director

Phone

(336) 846-2208

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306281600000",
    "number": "1154614063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 GENTRY ST",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "286409787",
            "telephone_number": "338-846-2208",
            "fax_number": "336-846-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 GENTRY ST",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "286409787",
            "telephone_number": "338-846-2208",
            "fax_number": "336-846-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT JEFFERSON CHILD DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-25",
        "last_updated": "2011-05-25",
        "status": "A",
        "authorized_official_last_name": "GOSS",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "CENTER DIRECTOR",
        "authorized_official_telephone_number": "336-846-2208",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NC",
            "license": "05000070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Patrick Mortimer, D.O.
• Mount Jefferson Family Medicine, P.a.
• Mountain Living Adult Care Home
• Mountainlife Home Care, Inc. (MountainLife In-Home Aide Service)
• MSP Boone Clinic, PLLC
• Uwe Mueller, RN
• Kinsey Nance, FNP
• Jessica R. Nelsen, DPT
• Angel Nelson, MS EDS LCMHCS BC-TMH
• New River Mental Health Center (New River Behavioral HealthCare)

• Early Intervention Provider Agency in Jefferson, NC
• Providers in Jefferson, NC by specialty
• Early Intervention Provider Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.