Active NPI
Granville-Vance District Health Department
- State or Local Public Health Clinic/Center
- Oxford, NC
National Provider Identifier
1194871970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- State or Local Public Health Clinic/Center
- Legal business name
- GRANVILLE-VANCE DISTRICT HEALTH DEPARTMENT
- Practice address
- 101 Hunt St
Oxford, NC 27565-3414 - Phone
- (919) 693-2141
- NPI assigned
- Jan 26, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Shauna Leigh Guthrie, MD
- Title
- Medical Director
- Phone
- (919) 693-2141
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | |||
| State or Local Public Health Clinic/Center | 261QP0905X | Primary |
Addresses
Primary practice location
101 Hunt St
Oxford, NC 27565-3414
Mailing address
101 Hunt St
PO Box 367
Oxford, NC 27565-3414
Phone (919) 693-2141
Other practice location 1
115 Charles Rollins Rd
Henderson, NC 27536-2946
Phone (252) 492-7915
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0721N | Other | BCBS GRANVILLE | |
| 3404416 | Medicaid | NC | |
| 3404391 | Medicaid | NC | |
| 3404339 | Medicaid | NC | |
| 0721P | Other | VANCE BCBS |
Other names 1
- Mass Immunizaton Services
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090521000383 | NC | Part B Supplier - Mass Immunization (Roster Biller Only) | 6305934753 | Practice locations: Oxford, NC |
| O20160509001632 | NC | Part B Supplier - Clinic/Group Practice | 6305934753 |
Receives reassigned benefits from 4 practitioners Practice locations: Henderson, NC; Oxford, NC |
National Provider Directory
National Provider DirectoryLocations
115 Charles Rollins Rd
Henderson, NC 27536
Phone 2524927915 ext. 260
1032 College St
Bldg B
Oxford, NC 27565
Phone (919) 693-2141
1032 College St
Oxford, NC 27565
Phone (919) 693-2141
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Registered Dietitian
- Oxford, NC
- NPI 1821501289
-
- Registered Dietitian
- Oxford, NC
- NPI 1366977373
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1566259200000",
"number": "1194871970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 HUNT ST",
"address_2": "PO BOX 367",
"city": "OXFORD",
"state": "NC",
"postal_code": "275653414",
"telephone_number": "919-693-2141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 HUNT ST",
"city": "OXFORD",
"state": "NC",
"postal_code": "275653414",
"telephone_number": "919-693-2141"
}
],
"practiceLocations": [
{
"address_1": "115 Charles Rollins Rd",
"address_purpose": "LOCATION",
"city": "Henderson",
"state": "NC",
"postal_code": "275362946",
"country_code": "US",
"telephone_number": "252-492-7915",
"fax_number": "252-492-4219",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "GRANVILLE-VANCE DISTRICT HEALTH DEPARTMENT",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-26",
"last_updated": "2019-08-20",
"status": "A",
"authorized_official_last_name": "GUTHRIE",
"authorized_official_first_name": "SHAUNA",
"authorized_official_middle_name": "LEIGH",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "919-693-2141",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QC1500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Community Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QP0905X",
"taxonomy_group": "",
"desc": "Clinic/Center, Public Health, State or Local",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GRANVILLE",
"identifier": "0721N",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3404416",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3404391",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3404339",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VANCE BCBS",
"identifier": "0721P",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Mass Immunizaton Services",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Mass Immunizaton Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Oxford, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.