NPIMap

Organization Active NPI

Granville-Vance District Health Department

Doing business as Mass Immunizaton Services

  • State or Local Public Health Clinic/Center
  • Oxford, NC
National Provider Identifier
1194871970
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
GRANVILLE-VANCE DISTRICT HEALTH DEPARTMENT
Doing business as
Mass Immunizaton Services
Practice address
101 Hunt St
Oxford, NC 27565-3414
Phone
(919) 693-2141
NPI assigned
Jan 26, 2007
Last updated
Aug 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Authorized official

Name
Dr. Shauna Leigh Guthrie, MDNPI 1609004936
Title
Medical Director
Phone
(919) 693-2141

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 names 1

  • Mass Immunizaton Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 Directory

Locations

101 Hunt Dr
Oxford, NC 27565
Phone (919) 693-2141

1032 College St
Bldg B
Oxford, NC 27565
Phone (919) 693-2141

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": [],
    "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.

Verify at the official NPI Registry.