NPIMap

Organization Active NPI

Community Innovations

  • Community/Behavioral Health Agency
  • Elizabethtown, NC
National Provider Identifier
1407057524
Registry record updated Oct 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY INNOVATIONS
Practice address
410 Peanut Plant Road
Elizabethtown, NC 28337
Phone
(910) 862-8363
NPI assigned
May 29, 2007
Last updated
Oct 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2008

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

Authorized official

Name
Andy Anderson
Title
President
Phone
(910) 642-5697

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

410 Peanut Plant Road
Elizabethtown, NC 28337

Mailing address

3210 Fairhill Dr
Raleigh, NC 27612-3220
Phone (919) 256-0824

Other identifiers 1

IdentifierTypeStateIssuer
6006054MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Community Innovationsinc48 organizations share this tax ID, including this one

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222819200000",
    "number": "1407057524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 FAIRHILL DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123220",
            "telephone_number": "919-256-0824",
            "fax_number": "919-256-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 PEANUT PLANT ROAD",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "28337",
            "telephone_number": "910-862-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY INNOVATIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2008-10-01",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-642-5697"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006054",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; 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.