NPIMap

Organization Active NPI

Johnston Memorial Hospital

  • Clinic/Center
  • Kenly, NC
National Provider Identifier
1295745099
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
9900728 Issued in NC
Legal business name
JOHNSTON MEMORIAL HOSPITAL
Practice address
400 N Englewood Dr
Kenly, NC 27542-9290
Phone
(919) 284-4149
Fax
(919) 284-6008
NPI assigned
Aug 8, 2006
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
Dr. Michael Vincent Woodbridge IV, MD
Title
Doctor
Phone
(919) 284-4149

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 9900728 NC Primary

Addresses

Primary practice location

400 N Englewood Dr
Kenly, NC 27542-9290

Mailing address

400 N Englewood Dr
Kenly, NC 27542-9290
Phone (919) 284-4149

Other identifiers 1

IdentifierTypeStateIssuer
891207EMedicaidNC

Other names 1

  • Johnston Family Care Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Johnston Family Care Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295745099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N ENGLEWOOD DR",
            "city": "KENLY",
            "state": "NC",
            "postal_code": "275429290",
            "telephone_number": "919-284-4149",
            "fax_number": "919-284-6008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N ENGLEWOOD DR",
            "city": "KENLY",
            "state": "NC",
            "postal_code": "275429290",
            "telephone_number": "919-284-4149",
            "fax_number": "919-284-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSTON MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WOODBRIDGE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "919-284-4149",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NC",
            "license": "9900728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891207E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johnston Family Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kenly, 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.