NPIMap

Organization Active NPI

Avalon # 3

  • Adult Care Home Facility
  • Raleigh, NC
National Provider Identifier
1447588751
Registry record updated Nov 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
AVALON # 3
Practice address
4133 White Pine Dr
Raleigh, NC 27612-3737
Phone
(336) 253-2219
Fax
(919) 872-7456
NPI assigned
Nov 24, 2009
Last updated
Nov 24, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2009

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

Authorized official

Name
Ijeoma NwankwoNPI 1154571511
Title
Owner
Phone
(336) 253-2219

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X NC Primary

Addresses

Primary practice location

4133 White Pine Dr
Raleigh, NC 27612-3737

Mailing address

4428 Louisburg Rd
Suite 109
Raleigh, NC 27616-4302
Phone (336) 253-2219

National Provider Directory

National Provider Directory
Tax ID family
Avalon 35 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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259020800000",
    "number": "1447588751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4428 LOUISBURG RD",
            "address_2": "SUITE 109",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276164302",
            "telephone_number": "336-253-2219",
            "fax_number": "919-872-7456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4133 WHITE PINE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123737",
            "telephone_number": "336-253-2219",
            "fax_number": "919-872-7456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON # 3",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-24",
        "last_updated": "2009-11-24",
        "status": "A",
        "authorized_official_last_name": "NWANKWO",
        "authorized_official_first_name": "IJEOMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-253-2219"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.