The Lighthouse Dialysis Foundation, Inc.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

THE LIGHTHOUSE DIALYSIS FOUNDATION, INC.

Practice address

2901 N Main St
Tarboro, NC 27886-1920

Phone

(252) 316-1033

Fax

(252) 822-0097

NPI assigned

Mar 7, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Nicole K Terry

Title

Chairwoman

Phone

(845) 659-7444

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362614400000",
    "number": "1417298951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S CHURCH ST",
            "address_2": "SUITE #260",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278045755",
            "telephone_number": "252-316-1033",
            "fax_number": "252-822-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 N MAIN ST",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278861920",
            "telephone_number": "252-316-1033",
            "fax_number": "252-822-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LIGHTHOUSE DIALYSIS FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-07",
        "last_updated": "2013-03-07",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHAIRWOMAN",
        "authorized_official_telephone_number": "845-659-7444",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Tarboro, NC
• Providers in Tarboro, NC by specialty
• Health Maintenance Organization in North Carolina

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