NPIMap

Organization Active NPI

University of North Carolina at Chapel Hill-Teacch Autism Program

  • Developmentally Disabled Services Day Training Agency
  • Greensboro, NC
National Provider Identifier
1437590106
Registry record updated Sep 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
3408563 Issued in NC
Legal business name
UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL-TEACCH AUTISM PROGRAM
Practice address
925 Revolution Mill Dr.
Greensboro, NC 27405
Phone
(336) 334-5773
Fax
(336) 334-5811
NPI assigned
Jul 10, 2013
Organization subpart
Yes
Parent organization
UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL-TEACCH AUTISM PROGRAMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 26, 2013

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

Authorized official

Name
Mr. Walter W. Kelly
Title
Business Officer
Phone
(919) 966-6636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 3408563 NC Primary

Addresses

Primary practice location

925 Revolution Mill Dr.
Greensboro, NC 27405

Mailing address

100 Renee Lynn CT
Carrboro, NC 27510-6511
Phone (919) 966-2173

Other identifiers 1

IdentifierTypeStateIssuer
3408563MedicaidNC

Other names 1

  • Greensboro TEACCH Autism Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Unc Phys and Assocs30 organizations share this tax ID, including this one
Part of
Unc Phys and Assocs

Other organizations with this tax ID 29

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

View all 29

Locations

925 Revolution Mill Dr
Greensboro, NC 27405
Phone (336) 334-5773

NPI Registry JSON

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1437590106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RENEE LYNN CT",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275106511",
            "telephone_number": "919-966-2173",
            "fax_number": "919-966-4127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 REVOLUTION MILL DR.",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27405",
            "telephone_number": "336-334-5773",
            "fax_number": "336-334-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL-TEACCH AUTISM PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL-TEACCH AUTISM PROGRAM",
        "enumeration_date": "2013-07-10",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "BUSINESS OFFICER",
        "authorized_official_telephone_number": "919-966-6636",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NC",
            "license": "3408563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408563",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greensboro TEACCH Autism Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.