NPIMap

Organization Active NPI

Halifax Regional Medical Center Inc

  • Urgent Care Clinic/Center
  • Roanoke Rapids, NC
National Provider Identifier
1275656118
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
HALIFAX REGIONAL MEDICAL CENTER INC
Practice address
210 A Smith Church Road
Roanoke Rapids, NC 27870-4942
Phone
(252) 535-8463
Fax
(252) 535-8137
NPI assigned
Apr 7, 2007
Organization subpart
Yes
Parent organization
HALIFAX REGIONAL MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Authorized official

Name
Sherry E Jensen
Title
VP Finance
Phone
(252) 535-8005

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary
Occupational Medicine Clinic/Center 261QX0100X

Addresses

Primary practice location

210 A Smith Church Road
Roanoke Rapids, NC 27870-4942

Mailing address

210 A Smith Church Rd
Roanoke Rapids, NC 27870-4942
Phone (252) 535-8463

Other names 1

  • Halifax Works Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000253 NC Part B Supplier - Clinic/Group Practice 5496664062 Receives reassigned benefits from 31 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Roanoke, NC; Roanoke Rapids, NC

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Camille Gagne-Sabbaghm

Locations

171 NC Highway 125
#B
Roanoke Rapids, NC 27870
Phone (252) 541-5552

210 Smith Church Rd
Ste A
Roanoke Rapids, NC 27870
Phone (252) 535-8463

Practitioners & affiliated clinicians

Practitioners 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1275656118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 A SMITH CHURCH RD",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278704942",
            "telephone_number": "252-535-8463",
            "fax_number": "252-535-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 A SMITH CHURCH ROAD",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278704942",
            "telephone_number": "252-535-8463",
            "fax_number": "252-535-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALIFAX REGIONAL MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HALIFAX REGIONAL MEDICAL CENTER INC",
        "enumeration_date": "2007-04-07",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "252-535-8005"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Halifax Works",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke Rapids, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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.