NPIMap

Organization Active NPI

North Carolina Central University

  • Family Medicine Physician
  • Durham, NC
National Provider Identifier
1437580107
Registry record updated Jul 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTH CAROLINA CENTRAL UNIVERSITY
Practice address
200 Cafeteria Drive
Durham, NC 27707
Phone
(919) 530-6317
Fax
(919) 530-7969
NPI assigned
Dec 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2024

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

Authorized official

Name
Tyrone Little
Title
Insurance Coordinator
Phone
(919) 530-5485

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Health Service Clinic/Center 261QH0100X
Student Health Clinic/Center 261QS1000X

Addresses

Primary practice location

200 Cafeteria Drive
Durham, NC 27707

Mailing address

1801 Fayetteville Street
Student Health Building
Durham, NC 27707
Phone (919) 530-7336

Other names 2

  • NCCU STUDENT HEALTH SERVICES Doing business as
  • North Carolina Central University Other name

National Provider Directory

National Provider Directory
Tax ID family
North Carolina Central University5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720137600000",
    "number": "1437580107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 FAYETTEVILLE STREET",
            "address_2": "STUDENT HEALTH BUILDING",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27707",
            "telephone_number": "919-530-7336",
            "fax_number": "919-530-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CAFETERIA DRIVE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27707",
            "telephone_number": "919-530-6317",
            "fax_number": "919-530-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA CENTRAL UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-06",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "TYRONE",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "919-530-5485"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NCCU STUDENT HEALTH SERVICES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Carolina Central University",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; 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.