Genesis Therapeutic Services, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

MHL-067-165 Issued in NC

Legal business name

GENESIS THERAPEUTIC SERVICES, INC.

Practice address

99 Village Dr Ste 12
Jacksonville, NC 28546-7060

Phone

(910) 577-8200

Fax

(910) 577-8270

NPI assigned

Feb 28, 2007

Last updated

Aug 22, 2020By 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

Kendrick Rogers

Title

Program Director

Phone

(910) 577-8200

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497882195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 VILLAGE DR STE 12",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467060",
            "telephone_number": "910-577-8200",
            "fax_number": "910-577-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 VILLAGE DR STE 12",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467060",
            "telephone_number": "910-577-8200",
            "fax_number": "910-577-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS THERAPEUTIC SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "KENDRICK",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "910-577-8200"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-067-165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409583",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300859G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300858B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300859",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300858G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300858",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300859B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ayla Gearhart
• Kayla Lynn Gee, PT, DPT
• Devinn L Geeson, DDS
• Zachary Geiger
• Generations Family Practice, PA (Andre KS Tse MD)
• Shelby Gentry
• Thomas Harrison Gentry III, IDC
• George a Howard, III MD (Onslow Radiology Center)
• Gail Debose Georgescu, LPA
• Rachel Lynn Gernert, LMFT

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.