Organization Active NPI

Family Psychiatri Care, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Gastonia, NC
National Provider Identifier
1194918433
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
200703 Issued in NC
Legal business name
FAMILY PSYCHIATRI CARE, PLLC
Practice address
1723 Armstrong Park Dr
Gastonia, NC 28054-4802
Phone
(704) 854-9828
NPI assigned
Aug 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

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

Authorized official

Name
Mrs. Susan Paulette Payne, FNPNPI 1699824391
Title
Owner
Phone
(704) 788-1572

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 200703 NC Primary

Addresses

Primary practice location

1723 Armstrong Park Dr
Gastonia, NC 28054-4802

Mailing address

1520 Chadmore LN NW
Concord, NC 28027-9084
Phone (704) 788-1572

Other identifiers 1

IdentifierTypeStateIssuer
6005040MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1194918433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 CHADMORE LN NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280279084",
            "telephone_number": "704-788-1572",
            "fax_number": "704-788-1572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 ARMSTRONG PARK DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544802",
            "telephone_number": "704-854-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PSYCHIATRI CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "PAULETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-788-1572",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "200703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005040",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.