Organization Active NPI

Solid Foundation Facilities Incorporated

  • Community/Behavioral Health Agency
  • Windsor, NC
National Provider Identifier
1164504395
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SOLID FOUNDATION FACILITIES INCORPORATED
Practice address
208 Dundee St
Windsor, NC 27983-6701
Phone
(252) 794-4800
Fax
(252) 794-4747
NPI assigned
Oct 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

Authorized official

Name
Mr. R. Vernell Rodgers
Title
Ceo President
Phone
(252) 794-2385

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 626 NC
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 626 NC
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 626 NC
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 626 NC
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

208 Dundee St
Windsor, NC 27983-6701

Mailing address

PO Box 709
224 Ward Road
Windsor, NC 27983-0709
Phone (252) 794-2385

Other identifiers 8

IdentifierTypeStateIssuer
3408848MedicaidNC
5906030MedicaidNC
8300759BMedicaidNC
8300759HMedicaidNC
232104OtherNCMEDICARE PTAN
8300760MedicaidNC
8300760HMedicaidNC
6005687MedicaidNC

National Provider Directory

National Provider Directory

Locations

1313 1st St W
Ahoskie, NC 27910
Phone (252) 209-8932

208 Dundee St
Windsor, NC 27983
Phone (252) 794-4800

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1164504395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 709",
            "address_2": "224 WARD ROAD",
            "city": "WINDSOR",
            "state": "NC",
            "postal_code": "279830709",
            "telephone_number": "252-794-2385",
            "fax_number": "252-794-1923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 DUNDEE ST",
            "city": "WINDSOR",
            "state": "NC",
            "postal_code": "279836701",
            "telephone_number": "252-794-4800",
            "fax_number": "252-794-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLID FOUNDATION FACILITIES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "R.",
        "authorized_official_middle_name": "VERNELL",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "252-794-2385",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "626",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NC",
            "license": "626",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "626",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "626",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408848",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906030",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300759B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300759H",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "232104",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300760",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300760H",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005687",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.