Genesis Developmental Services

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

License

ITFS Issued in NC

Legal business name

GENESIS DEVELOPMENTAL SERVICES

Practice address

123 Harris Rd
Smithfield, NC 27577-8161

Phone

(919) 437-2156

NPI assigned

Aug 6, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Ivis S Fuentes, ITFSNPI 1780027300

Title

Developmental Therapist

Phone

(919) 437-2156

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ivis S Fuentes, ITFS

  • Developmental Therapist
  • Smithfield, NC
  • NPI 1780027300
  NPD (past) Authorized official

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375833600000",
    "number": "1346672912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 HARRIS RD",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275778161",
            "telephone_number": "919-437-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HARRIS RD",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275778161",
            "telephone_number": "919-437-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS DEVELOPMENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-06",
        "last_updated": "2013-08-07",
        "status": "A",
        "authorized_official_last_name": "FUENTES",
        "authorized_official_first_name": "IVIS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DEVELOPMENTAL THERAPIST",
        "authorized_official_telephone_number": "919-437-2156",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ITFS"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Developmental Therapist",
            "state": "NC",
            "license": "ITFS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Walker Garris, PHARM.D.
• Cynthia Marie Gary, PA
• D'Myia Gause, SLP
• Miroslav Gavazov, M.D.
• Deborah Ann Geib, LPTA
• Gentle Touch Phlebotomy & Wellness Center, LLC
• Anastasia Gibson
• Ajmal Masood Gilani, M.D.
• Veselin Stoyanov Gizdarski, M.D.
• Eric John Gloss, DO

• Developmental Therapist in Smithfield, NC
• Providers in Smithfield, NC by specialty
• Developmental Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; 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.