Individual provider Active NPI

Katherine N Valentine-Blount

  • Addiction (Substance Use Disorder) Registered Nurse
  • Ahoskie, NC
National Provider Identifier
1306003116
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
307575 Issued in NC
Practice address
228 Main St E
Ahoskie, NC 27910-3418
Phone
(252) 287-0213
Fax
(252) 287-0213
NPI assigned
May 20, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Pastoral Counselor 101YP1600X
Clinical Social Worker 1041C0700X
Administrator Registered Nurse 163WA2000X 307575 NC
Peer Specialist 175T00000X
Clinical Medical Laboratory 291U00000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 307575 NC Primary
Contractor 171W00000X

Addresses

Primary practice location

228 Main St E
Ahoskie, NC 27910-3418

Mailing address

926 1St St E
Ahoskie, NC 27910-3104
Phone (252) 287-0213

Other practice location 1

6512 Suburban Dr
2A
Raleigh, NC 27615-6734
Phone (919) 758-8870

Other identifiers 1

IdentifierTypeStateIssuer
1306003116MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
307575NCMDAdministrator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
A New Beginning for 1 Life Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1306003116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 1ST ST E",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279103104",
            "telephone_number": "252-287-0213",
            "fax_number": "252-287-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 MAIN ST E",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279103418",
            "telephone_number": "252-287-0213",
            "fax_number": "252-287-0213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6512 Suburban Dr",
            "address_2": "2A",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276156734",
            "country_code": "US",
            "telephone_number": "919-758-8870",
            "fax_number": "919-758-8870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALENTINE-BLOUNT",
        "first_name": "KATHERINE",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "NC",
            "license": "307575",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "307575",
            "primary": true
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306003116",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ahoskie, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.