Organization Active NPI

North Raleigh Family Clinic

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1346276565
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C000909 Issued in NC
Legal business name
NORTH RALEIGH FAMILY CLINIC
Practice address
5850 Faringdon PL
Raleigh, NC 27609-3930
Phone
(919) 872-9974
NPI assigned
Jun 23, 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
Chad Jordan, LMFT
Title
Clinic Administrator
Phone
(919) 872-9974

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X C000909 NC Primary

Addresses

Primary practice location

5850 Faringdon PL
Raleigh, NC 27609-3930

Mailing address

5850 Faringdon PL
Raleigh, NC 27609-3930
Phone (919) 872-9974

Other identifiers 2

IdentifierTypeStateIssuer
6005799MedicaidNC
5903347MedicaidNC

National Provider Directory

National Provider Directory

Locations

5850 Faringdon Pl
Raleigh, NC 27609
Phone (919) 633-7230

Practitioners & affiliated clinicians

Practitioners 3

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": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346276565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 FARINGDON PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276093930",
            "telephone_number": "919-872-9974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 FARINGDON PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276093930",
            "telephone_number": "919-872-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH RALEIGH FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "919-872-9974",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C000909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005799",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903347",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, 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.