NPIMap

Organization Active NPI

Peterkin & Associates, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Southern Pines, NC
National Provider Identifier
1508996059
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
MHL-063-017 Issued in NC
Legal business name
PETERKIN & ASSOCIATES, INC.
Practice address
114 Greenhouse LN
Southern Pines, NC 28387-3140
Phone
(910) 323-1817
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Authorized official

Name
Mrs. Alice Smith, ED.D
Title
Ceo
Phone
(910) 323-1817

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X MHL-063-017 NC
Mental Illness Intermediate Care Facility 310500000X MHL-063-017 NC
Intellectual Disabilities Intermediate Care Facility 315P00000X MHL-063-017 NC Primary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL-063-017 NC

Addresses

Primary practice location

114 Greenhouse LN
Southern Pines, NC 28387-3140

Mailing address

131 Hay St Ste 201
Fayetteville, NC 28301-5649
Phone (910) 323-1817

Other identifiers 1

IdentifierTypeStateIssuer
340604WMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Peterkin Associates Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1508996059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 HAY ST STE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015649",
            "telephone_number": "910-323-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 GREENHOUSE LN",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283873140",
            "telephone_number": "910-323-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERKIN & ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-323-1817",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ED.D"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "MHL-063-017",
            "primary": false
        },
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-063-017",
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NC",
            "license": "MHL-063-017",
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-063-017",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340604W",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southern Pines, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.