NPIMap

Organization Active NPI

J Iverson Riddle Developmental Center

  • Dental Clinic/Center
  • Morganton, NC
National Provider Identifier
1194861617
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
J IVERSON RIDDLE DEVELOPMENTAL CENTER
Practice address
300 Enola Rd
Morganton, NC 28655-4608
Phone
(828) 608-6000
Fax
(828) 608-6910
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

300 Enola Rd
Morganton, NC 28655-4608

Mailing address

300 Enola Road
Morgantown, NC 28655-4608
Phone (828) 433-2722

Other identifiers 1

IdentifierTypeStateIssuer
3406014MedicaidNC

Other names 1

  • Western Carolina Center Other name

National Provider Directory

National Provider Directory
Tax ID family
J Iverson Riddle Developmental Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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": "1736380800000",
    "number": "1194861617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 ENOLA ROAD",
            "city": "MORGANTOWN",
            "state": "NC",
            "postal_code": "286554608",
            "telephone_number": "828-433-2722",
            "fax_number": "828-433-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ENOLA RD",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286554608",
            "telephone_number": "828-608-6000",
            "fax_number": "828-608-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J IVERSON RIDDLE DEVELOPMENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "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": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406014",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western Carolina Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Western Carolina Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Morganton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.