NPIMap

Organization Active NPI

Martha's Group Homes, Inc

  • Clinical Social Worker
  • Jacksonville, NC
National Provider Identifier
1578752770
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PENDING Issued in NC
Legal business name
MARTHA'S GROUP HOMES, INC
Practice address
516 E Springhill Ter
Jacksonville, NC 28546-7366
Phone
(910) 938-0670
Fax
(910) 938-1229
NPI assigned
Oct 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Authorized official

Name
Thomas Trevour Shepard, MFA,QMHP
Title
Ceo
Phone
(910) 938-0670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X PENDING NC Primary

Addresses

Primary practice location

516 E Springhill Ter
Jacksonville, NC 28546-7366

Mailing address

516 E Springhill Ter
Jacksonville, NC 28546-7366
Phone (910) 938-0670

National Provider Directory

National Provider Directory
Tax ID family
Martha's Group Homes Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1578752770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 E SPRINGHILL TER",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467366",
            "telephone_number": "910-938-0670",
            "fax_number": "910-938-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E SPRINGHILL TER",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467366",
            "telephone_number": "910-938-0670",
            "fax_number": "910-938-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA'S GROUP HOMES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "SHEPARD",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "TREVOUR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-938-0670",
        "authorized_official_credential": "MFA,QMHP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.