NPIMap

Organization Active NPI

Peterkin and Associates, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Fayetteville, NC
National Provider Identifier
1548356355
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
MHL-026-017 Issued in NC
Legal business name
PETERKIN AND ASSOCIATES, INC.
Practice address
131 Hay St.
Suite 201
Fayetteville, NC 28301-5649
Phone
(910) 323-1817
Fax
(910) 323-2607
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Authorized official

Name
Dr. Alice D. Smith, ED.D.
Title
Executive Director
Phone
(910) 323-1817

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X MHL-026-017 NC Primary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X MHL-026-049 NC
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X MHL-026-097 NC
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X MHL-026-071 NC
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X MHL-063-016 NC
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X MHL-063-017 NC

Addresses

Primary practice location

131 Hay St.
Suite 201
Fayetteville, NC 28301-5649

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
8300766MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Innovative Programming Associates Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278892800000",
    "number": "1548356355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 HAY ST.",
            "address_2": "SUITE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015649",
            "telephone_number": "910-323-1817",
            "fax_number": "910-323-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 HAY ST.",
            "address_2": "SUITE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015649",
            "telephone_number": "910-323-1817",
            "fax_number": "910-323-2607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERKIN AND ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2010-07-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "910-323-1817",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-026-017",
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-026-049",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-026-097",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-026-071",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-063-016",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-063-017",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300766",
            "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 Jul 12, 2010; 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.