NPIMap

Organization Active NPI

Peterkin and Associates, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Goldsboro, NC
National Provider Identifier
1548394828
Registry record updated Dec 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
PETERKIN AND ASSOCIATES, INC.
Practice address
212 E. Walnut Street
Goldsboro, NC 27530-4835
Phone
(919) 739-5637
Fax
(919) 739-5636
NPI assigned
Mar 16, 2007
Last updated
Dec 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2009

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

Authorized official

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NC
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

212 E. Walnut Street
Goldsboro, NC 27530-4835

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
8302051MedicaidNC
8302051AMedicaidNC
8302051BMedicaidNC

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.

Locations

212 E Walnut St
Goldsboro, NC 27530
Phone (919) 739-5637

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259884800000",
    "number": "1548394828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 HAY STREET,",
            "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": "212 E. WALNUT STREET",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275304835",
            "telephone_number": "919-739-5637",
            "fax_number": "919-739-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERKIN AND ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2009-12-04",
        "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": "Mrs.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302051",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302051A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302051B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; 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.