NPIMap

Organization Active NPI

Integrated Care of Greater Hickory, Inc

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Lincolnton, NC
National Provider Identifier
1194219931
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
Legal business name
INTEGRATED CARE OF GREATER HICKORY, INC
Practice address
1228 N Flint St
Lincolnton, NC 28092-5239
Phone
(828) 322-5915
NPI assigned
Jun 15, 2018
Last updated
Jun 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Authorized official

Name
Elbert Andrew Rudisill, MD
Title
President
Phone
(828) 322-5915

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Addiction Medicine (Family Medicine) Physician 207QA0401X NU
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X NU Primary

Addresses

Primary practice location

1228 N Flint St
Lincolnton, NC 28092-5239

Mailing address

1228 N Flint St
Lincolnton, NC 28092-5239
Phone (828) 322-5915

Other identifiers 2

IdentifierTypeStateIssuer
8973845MedicaidNC
8902716MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Integrated Care of Greater Hickory Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

1228 N Flint St
Lincolnton, NC 28092

NPI Registry JSON

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529020800000",
    "number": "1194219931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 N FLINT ST",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280925239",
            "telephone_number": "828-322-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 N FLINT ST",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280925239",
            "telephone_number": "828-322-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED CARE OF GREATER HICKORY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-15",
        "last_updated": "2018-06-15",
        "status": "A",
        "authorized_official_last_name": "RUDISILL",
        "authorized_official_first_name": "ELBERT",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "828-322-5915",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8973845",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902716",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; 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.