NPIMap

Organization Active NPI

Fenix Holistic, PLLC

  • General Practice Physician
  • Linden, NC
National Provider Identifier
1316565260
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
FENIX HOLISTIC, PLLC
Practice address
20 Farrow CT
Linden, NC 28356-1007
Phone
(910) 600-9488
Fax
(307) 419-2656
NPI assigned
Jul 8, 2020
Last updated
Jul 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Authorized official

Name
Ron'Nisha D Baldwin, NPNPI 1790295483
Title
NP
Phone
(910) 918-0633

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X NU
General Practice Physician 208D00000X NU Primary
Nurse Practitioner 363L00000X NU
Addiction Medicine (Preventive Medicine) Physician 2083A0300X NU

Addresses

Primary practice location

20 Farrow CT
Linden, NC 28356-1007

Mailing address

20 Farrow CT
Linden, NC 28356-1007

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21956/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594166400000",
    "number": "1316565260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 FARROW CT",
            "city": "LINDEN",
            "state": "NC",
            "postal_code": "283561007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 FARROW CT",
            "city": "LINDEN",
            "state": "NC",
            "postal_code": "283561007",
            "telephone_number": "910-600-9488",
            "fax_number": "307-419-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FENIX HOLISTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A",
        "authorized_official_last_name": "BALDWIN",
        "authorized_official_first_name": "RON'NISHA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "910-918-0633",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linden, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.