NPIMap

Organization Active NPI

Sixth Avenue Psychiatric Rehabilitation Partners

  • Physician Assistant
  • Hendersonville, NC
National Provider Identifier
1194877357
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
101236 Issued in NC
Legal business name
SIXTH AVENUE PSYCHIATRIC REHABILITATION PARTNERS
Practice address
527 N Justice St
Hendersonville, NC 28739-4217
Phone
(828) 697-9765
NPI assigned
Jan 17, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mary Jo Stark
Title
Office Administrator
Phone
(828) 697-1581

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 101236 NC Primary

Addresses

Primary practice location

527 N Justice St
Hendersonville, NC 28739-4217

Mailing address

714 6TH Ave W
Hendersonville, NC 28739-4114

Other identifiers 1

IdentifierTypeStateIssuer
8301703MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Sixth Avenue Psychiatric Rehabilitation Partners Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194877357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 6TH AVE W",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287394114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 N JUSTICE ST",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287394217",
            "telephone_number": "828-697-9765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIXTH AVENUE PSYCHIATRIC REHABILITATION PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "MARY JO",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "828-697-1581"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301703",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.