NPIMap

Organization Active NPI

Robeson Health Care Corporation

Doing business as RHCC Mobile Unit

  • Federally Qualified Health Center (FQHC)
  • Pembroke, NC
National Provider Identifier
1508522996
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ROBESON HEALTH CARE CORPORATION
Doing business as
RHCC Mobile Unit
Practice address
307 E Wardell Dr
Pembroke, NC 28372-7998
Phone
(910) 521-2816
Fax
(910) 521-3583
NPI assigned
Nov 10, 2021
Last updated
Mar 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Authorized official

Name
George Timothy Hall
Title
Ceo
Phone
(910) 521-2900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

307 E Wardell Dr
Pembroke, NC 28372-7998

Mailing address

60 Commerce Plaza Cir
Pembroke, NC 28372-7386
Phone (910) 521-2900

Other names 1

  • RHCC MOBILE UNIT Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031231000292 NC Part B Supplier - Clinic/Group Practice 1850290693 Receives reassigned benefits from 27 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Red Springs, NC; Smithfield, NC; Saint Pauls, NC; Pembroke, NC; Maxton, NC; Lumberton, NC; Fairmont, NC; Laurinburg, NC…
O20221011002815 NC Part A Provider - Federally Qualified Health Center (FQHC) 1850290693 Practice locations: Pembroke, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508522996. Details of each certification follow.

Federally qualified health center certification: CCN 341172

Legal name
ROBESON HEALTH CARE CORPORATION
Doing business as
RHCC MOBILE UNIT
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 15, 2021
Last certification
Dec 15, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 27, 1985 in NC
Enrollment address
307 E Wardell Dr
Pembroke, NC 28372-7998

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Robeson Health Care Corporation16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Henry Junior Shamburger Individual Corporate Director Jul 1, 2019
George Timothy Hall Individual Corporate OfficerChief Executive Officer Mar 8, 2016
W-2 Managing EmployeeChief Executive Officer Mar 8, 2016
Kristy Lynn Locklear Individual Corporate OfficerChief Financial Officer Mar 8, 2016
W-2 Managing EmployeeChief Financial Officer Mar 8, 2016
Denise Hunt Individual Corporate Director Jul 1, 2019
Sheena Marie Hunt Individual Corporate Director Jul 1, 2019
Bobby Townsend Individual Corporate Director Jul 1, 2021

NPI Registry JSON

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1508522996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 COMMERCE PLAZA CIR",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283727386",
            "telephone_number": "910-521-2900",
            "fax_number": "910-775-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E WARDELL DR",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283727998",
            "telephone_number": "910-521-2816",
            "fax_number": "910-521-3583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBESON HEALTH CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-10",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-521-2900"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RHCC MOBILE UNIT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pembroke, NC

Sources for this page

Verify at the official NPI Registry.