NPIMap

Organization Active NPI

Longleaf Neuro-Medical Treatment Center

  • Alzheimer Center (Dementia Center)
  • Wilson, NC
National Provider Identifier
1174669691
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Alzheimer Center (Dementia Center)Taxonomy code 311500000X
Legal business name
LONGLEAF NEURO-MEDICAL TREATMENT CENTER
Practice address
4761 Ward Blvd
Wilson, NC 27893
Phone
(252) 399-2112
Fax
(252) 399-2138
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Karen Burkes
Title
Division Director
Phone
(919) 855-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Alzheimer Center (Dementia Center) 311500000X Primary

Addresses

Primary practice location

4761 Ward Blvd
Wilson, NC 27893

Mailing address

4761 Ward Blvd
Wilson, NC 27893-4359
Phone (252) 399-2112

National Provider Directory

National Provider Directory
Tax ID family
Longleaf Neuro-Medical Treatment Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1174669691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4761 WARD BLVD",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934359",
            "telephone_number": "252-399-2112",
            "fax_number": "252-399-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4761 WARD BLVD",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "27893",
            "telephone_number": "252-399-2112",
            "fax_number": "252-399-2138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGLEAF NEURO-MEDICAL TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "BURKES",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "DIVISION DIRECTOR",
        "authorized_official_telephone_number": "919-855-4700"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.