NPIMap

Organization Active NPI

Southmountain Children and Family Services

  • Pediatric Nurse Practitioner
  • Morganton, NC
National Provider Identifier
1447437785
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
Legal business name
SOUTHMOUNTAIN CHILDREN AND FAMILY SERVICES
Doing business as
The Gingerbread House-Burke Child Advocacy Center
Practice address
408 S Green St
Morganton, NC 28655-3529
Phone
(828) 430-9949
Fax
(828) 433-1268
NPI assigned
Jan 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Authorized official

Name
Mr. W. Chris Jernigan
Title
Executive Director
Phone
(828) 584-1105

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X Primary

Addresses

Primary practice location

408 S Green St
Morganton, NC 28655-3529

Mailing address

PO Box 3387
Morganton, NC 28680-3387
Phone (828) 391-2803

Other identifiers 1

IdentifierTypeStateIssuer
5908895MedicaidNC

Other names 1

  • The Gingerbread House-Burke Child Advocacy Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southmountain Children and Family Services24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558051200000",
    "number": "1447437785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3387",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286803387",
            "telephone_number": "828-391-2803",
            "fax_number": "828-584-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 S GREEN ST",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286553529",
            "telephone_number": "828-430-9949",
            "fax_number": "828-433-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHMOUNTAIN CHILDREN AND FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2019-05-17",
        "status": "A",
        "authorized_official_last_name": "JERNIGAN",
        "authorized_official_first_name": "W.",
        "authorized_official_middle_name": "CHRIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "828-584-1105",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908895",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Gingerbread House-Burke Child Advocacy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Gingerbread House-Burke Child Advocacy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morganton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; 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.