NPIMap

Organization Active NPI

Easter Seals Ucp North Carolina & Virginia, Inc.

  • Community/Behavioral Health Agency
  • Yanceyville, NC
National Provider Identifier
1437367174
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Practice address
1076 NC Highway 86 N
Yanceyville, NC 27379-8645
Phone
(336) 694-1487
Fax
(336) 694-1681
NPI assigned
May 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Authorized official

Name
Nasheba Key-Allred
Title
Contract Specialist
Phone
(919) 783-8898

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1076 NC Highway 86 N
Yanceyville, NC 27379-8645

Mailing address

5171 Glenwood Ave
Suite 211
Raleigh, NC 27612-3266
Phone (919) 783-8898

Other identifiers 3

IdentifierTypeStateIssuer
018KJOtherNCBCBS
8301522MedicaidNC
8301522AMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101105000534 NC Part B Supplier - Clinic/Group Practice 7618161407 Receives reassigned benefits from 79 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Raleigh, NC; Jacksonville, NC; New Bern, NC; Nags Head, NC; Mount Airy, NC; Morganton, NC; Morehead City, NC; Kinston, NC…

National Provider Directory

National Provider Directory
Tax ID family
Easter Seals Ucp North Carolina Virginia Inc224 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492992000000",
    "number": "1437367174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 GLENWOOD AVE",
            "address_2": "SUITE 211",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123266",
            "telephone_number": "919-783-8898",
            "fax_number": "919-782-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 NC HIGHWAY 86 N",
            "city": "YANCEYVILLE",
            "state": "NC",
            "postal_code": "273798645",
            "telephone_number": "336-694-1487",
            "fax_number": "336-694-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2017-04-24",
        "status": "A",
        "authorized_official_last_name": "KEY-ALLRED",
        "authorized_official_first_name": "NASHEBA",
        "authorized_official_title_or_position": "CONTRACT SPECIALIST",
        "authorized_official_telephone_number": "919-783-8898"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "018KJ",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301522",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301522A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yanceyville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.