NPIMap

Organization Active NPI

Omni Visions, Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • North Wilkesboro, NC
National Provider Identifier
1235207374
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
NA Issued in NC
Legal business name
OMNI VISIONS, INC
Practice address
910 C St
Suite 8
North Wilkesboro, NC 28659-4145
Phone
(336) 838-2412
Fax
(336) 667-5773
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Authorized official

Name
Brelyn Waddell
Title
Ar Manager
Phone
(919) 334-0249

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X SO 09985A TN
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NA NC Primary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 50053 KY

Addresses

Primary practice location

910 C St
Suite 8
North Wilkesboro, NC 28659-4145

Mailing address

301 S Perimeter Park Dr
Suite 210
Nashville, TN 37211-4143
Phone (615) 726-3603

Other identifiers 5

IdentifierTypeStateIssuer
8301141MedicaidNC
8301141BMedicaidNC
8301141IMedicaidNC
8301141GMedicaidNC
8301141HMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Omni Visions Inc51 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332115200000",
    "number": "1235207374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S PERIMETER PARK DR",
            "address_2": "SUITE 210",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372114143",
            "telephone_number": "615-726-3603",
            "fax_number": "615-726-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 C ST",
            "address_2": "SUITE 8",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286594145",
            "telephone_number": "336-838-2412",
            "fax_number": "336-667-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI VISIONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2012-03-19",
        "status": "A",
        "authorized_official_last_name": "WADDELL",
        "authorized_official_first_name": "BRELYN",
        "authorized_official_title_or_position": "AR MANAGER",
        "authorized_official_telephone_number": "919-334-0249"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TN",
            "license": "SO 09985A",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "NA",
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "KY",
            "license": "50053",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301141",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301141B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301141I",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301141G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301141H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Wilkesboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.