Active NPI
Cherry Hospital
- Psychiatric Hospital
- Goldsboro, NC
National Provider Identifier
1306974068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital
- Legal business name
- CHERRY HOSPITAL
- Practice address
- 201 Stevens Mill Road
Goldsboro, NC 27530-1056 - Phone
- (919) 731-3204
- Fax
- (919) 731-3785
- NPI assigned
- Mar 2, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. J Michael Hennike
- Title
- Section Chief of DMH DD Sas State O
- Phone
- (919) 855-4700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | Primary |
Addresses
Primary practice location
201 Stevens Mill Road
Goldsboro, NC 27530-1056
Mailing address
201 Stevens Mill Road
Goldsboro, NC 27530-1056
Phone (919) 731-3204
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3404003 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Hospital certification: CCN 344003
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- CHERRY HOSPITAL
- Certification status
- Terminated Involuntary: failure to meet health/safety requirements, Sep 1, 2008
- Provider type (POS)
- Hospital – Psychiatric
- Participating since
- Jul 1, 1966
- Last certification
- Aug 31, 2008
- Beds
- 403 (324 certified)
- Ownership / control type
- State
- Facility address
- 201 Stevens Mill Road
Goldsboro, NC 27530
National Provider Directory
National Provider Directory- Tax ID family
- Cherry Hospital
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Institutional Pharmacy
- Goldsboro, NC
- NPI 1548316979
Locations
201 Stevens Mill Rd
Goldsboro, NC 27530
Phone (919) 731-3206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1306974068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 STEVENS MILL ROAD",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275301056",
"telephone_number": "919-731-3204",
"fax_number": "919-731-3785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 STEVENS MILL ROAD",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275301056",
"telephone_number": "919-731-3204",
"fax_number": "919-731-3785"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHERRY HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-02",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "HENNIKE",
"authorized_official_first_name": "J",
"authorized_official_middle_name": "MICHAEL",
"authorized_official_title_or_position": "SECTION CHIEF OF DMH DD SAS STATE O",
"authorized_official_telephone_number": "919-855-4700",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3404003",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Goldsboro, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.