Organization Active NPI

Daisy C. Palms Adult Care, Inc

  • Health Service Clinic/Center
  • Fayetteville, NC
National Provider Identifier
1487838975
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
FCL026044 Issued in NC
Legal business name
DAISY C. PALMS ADULT CARE, INC
Practice address
1715 Stratford Rd
Fayetteville, NC 28304-1425
Phone
(910) 485-6610
NPI assigned
Dec 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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

Authorized official

Name
Mrs. Daisy C Palms
Title
Owner
Phone
(910) 485-6610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X FCL026044 NC Primary

Addresses

Primary practice location

1715 Stratford Rd
Fayetteville, NC 28304-1425

Mailing address

1715 Stratford Rd
Fayetteville, NC 28304-1425
Phone (910) 485-6610

Other identifiers 1

IdentifierTypeStateIssuer
7804849MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1487838975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 STRATFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283041425",
            "telephone_number": "910-485-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 STRATFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283041425",
            "telephone_number": "910-485-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAISY C. PALMS ADULT CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "PALMS",
        "authorized_official_first_name": "DAISY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-485-6610",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NC",
            "license": "FCL026044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804849",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; 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.