Guilford County Department of Public Health

Primary specialty

State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X

Legal business name

GUILFORD COUNTY DEPARTMENT OF PUBLIC HEALTH

Practice address

501 E Green Dr
Adult Immunization Services
High Point, NC 27260-6707

Phone

(336) 845-7990

Fax

(336) 845-7987

NPI assigned

Feb 23, 2007

Organization subpart

Yes

Parent organization

GUILFORD COUNTY DEPARTMENT OF PUBLIC HEALTHAs reported in NPPES

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

Authorized official

Name

Harvette C Jenkins, MD

Title

Medical Director

Phone

(336) 641-7777

Specialties & licenses 6

Addresses

Other identifiers 3

Other names 1

• GCDPH ADULT IMMUNIZATION Other name

Part of

Guilford Co DPT Pub HLT

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229558400000",
    "number": "1164557567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E WENDOVER AVE",
            "address_2": "ADULT IMMUNIZATION ADMINISTRATION",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056713",
            "telephone_number": "336-647-1777",
            "fax_number": "336-641-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E GREEN DR",
            "address_2": "ADULT IMMUNIZATION SERVICES",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272606707",
            "telephone_number": "336-845-7990",
            "fax_number": "336-845-7987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUILFORD COUNTY DEPARTMENT OF PUBLIC HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUILFORD COUNTY DEPARTMENT OF PUBLIC HEALTH",
        "enumeration_date": "2007-02-23",
        "last_updated": "2008-12-18",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "HARVETTE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "336-641-7777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NC",
            "license": "34D0238958",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NC",
            "license": "34D0664205",
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "01-07677",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "07124",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "AS34604210001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GCDPH ADULT IMMUNIZATION",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Guilford County Community Connections, Inc.
• Guilford County Department of Public Health
• Guilford County Department of Public Health
• Guilford County Department of Public Health
• Guilford County Department of Public Health
• Guilford County Department of Public Health
• Guilford County Department of Public Health
• Guilford County Department of Public Health
• Guilford County Department of Public Health
• Guilford County Department of Public Health

• State or Local Public Health Clinic/Center in High Point, NC
• Providers in High Point, NC by specialty
• State or Local Public Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.