Organization Active NPI

Trinity Manor of Kinston

  • Health Service Clinic/Center
  • Kinston, NC
National Provider Identifier
1285818765
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
HAL054003 Issued in NC
Legal business name
TRINITY MANOR OF KINSTON
Practice address
1406 E Shine St
Kinston, NC 28501-5836
Phone
(252) 527-0438
NPI assigned
Dec 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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

Authorized official

Name
Mr. Robert C. Boone
Title
Owner
Phone
(252) 527-0438

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X HAL054003 NC Primary

Addresses

Primary practice location

1406 E Shine St
Kinston, NC 28501-5836

Mailing address

1406 E Shine St
Kinston, NC 28501-5836
Phone (252) 527-0438

Other identifiers 1

IdentifierTypeStateIssuer
7801483MedicaidNC

National Provider Directory

National Provider Directory

Locations

1406 E Shine St
Kinston, NC 28501
Phone (252) 527-0438

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1285818765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 E SHINE ST",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285015836",
            "telephone_number": "252-527-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 E SHINE ST",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285015836",
            "telephone_number": "252-527-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY MANOR OF KINSTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "BOONE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-527-0438",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NC",
            "license": "HAL054003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801483",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinston, NC

Sources for this page

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