Montgomery County Free Clinic

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

5005256 Issued in NC

Legal business name

MONTGOMERY COUNTY FREE CLINIC

Practice address

104 Professional Drive
Biscoe, NC 27209

Phone

(910) 428-9020

NPI assigned

Aug 26, 2011

Last updated

Aug 26, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Benita Watson

Title

Director

Phone

(910) 428-9020

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1314316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314316800000",
    "number": "1487934006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 296",
            "address_2": "104 PROFESSIONAL DRIVE",
            "city": "BISCOE",
            "state": "NC",
            "postal_code": "27209",
            "telephone_number": "910-428-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 PROFESSIONAL DRIVE",
            "city": "BISCOE",
            "state": "NC",
            "postal_code": "27209",
            "telephone_number": "910-428-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY COUNTY FREE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-26",
        "last_updated": "2011-08-26",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "BENITA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-428-9020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NC",
            "license": "5005256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Noelle Lee, FNP
• Theresa Cranford Lee, NP
• David Arthur Levenite, RBT
• Rebecca Locklear, APRN
• Monarch
• National Mentor Healthcare, LLC (NC Mentor)
• National Mentor Healthcare, LLC (NC Mentor)
• National Mentor Healthcare, LLC (North Carolina Mentor)
• National Mentor Healthcare, LLC (North Carolina Mentor)
• Neal and Joyce Parson (Baaseiah Family Care Home II)

• Public Health or Welfare Agency in Biscoe, NC
• Providers in Biscoe, NC by specialty
• Public Health or Welfare Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; 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.