NPIMap

Organization Active NPI

Rural Health Group, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jackson, NC
National Provider Identifier
1598893547
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
RURAL HEALTH GROUP, INC.
Practice address
9409 NC Highway 305
Jackson, NC 27845-9679
Phone
(252) 536-5920
Fax
(252) 534-2041
NPI assigned
Mar 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Authorized official

Name
Yvonne Long-Gee
Title
Ceo
Phone
(252) 536-5789

Specialties & licenses 1

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

Addresses

Primary practice location

9409 NC Highway 305
Jackson, NC 27845-9679

Mailing address

PO Box 640
Roanoke Rapids, NC 27870-0640
Phone (252) 536-5440

Other names 1

  • Rural Health Group at Jackson/Dental Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050708000124 NC Part B Supplier - Clinic/Group Practice 9739090226 Receives reassigned benefits from 81 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Enfield, NC; Whitakers, NC; Weldon, NC; Stovall, NC; Scotland Neck, NC; Roanoke Rapids, NC; Norlina, NC; Littleton, NC…
O20230525001509 NC Part A Provider - Federally Qualified Health Center (FQHC) 9739090226 Practice locations: Jackson, NC

Federally qualified health center certification: CCN 861132

Legal name
RURAL HEALTH GROUP INC
Doing business as
RURAL HEALTH GROUP AT JACKSON/DENTAL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 25, 2023
Last certification
May 25, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 4, 1985 in NC
Enrollment address
9409 NC Highway 305
Jackson, NC 27845-9679

Other NPIs with the same Medicare PAC ID 18

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

View all 18

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Rural Health Group Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Willie McKinley Greene Individual Corporate DirectorBoard Member May 1, 2007
Chester Bruce Williams Individual Corporate DirectorBoard Member Sep 24, 2015
Gary Lavern Wingfield Individual Corporate DirectorBoard Member Aug 18, 2019
Krystian Gayle Latham Individual Corporate DirectorBoard Member Feb 24, 2022
Ella Green Viverette Individual Corporate DirectorBoard Member May 1, 2007
Jimille Evans Mills Individual Corporate DirectorBoard Member Jan 28, 2021
Cynthia Lynette Brown Individual Corporate DirectorBoard Member May 1, 2007
Yvonne Long Gee Individual Corporate OfficerCeo Jan 27, 2018
Wilhelmena Rae Herritage Mitchell Individual Corporate DirectorBoard Member May 1, 2007
Judy Belch Beasley Individual W-2 Managing Employee May 1, 2007
Sara Myrick Council Individual Corporate DirectorBoard Member Mar 17, 2019
Jimmie Lewis Sidberry Individual Corporate DirectorBoard Member Apr 25, 2013
Clyde Anthony Johnston Individual Corporate DirectorBoard Member May 1, 2007
Lutricia Lynch Lewis Individual Corporate DirectorBoard Member May 1, 2007
Audrey Lee Hardy Individual Corporate DirectorBoard Member Sep 24, 2015

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rural Health Group at HendersonHenderson, NC, CCN 341946 Federally qualified health center Operational/Managerial Control Aug 31, 2009
Rural Health Group at EnfieldEnfield, NC, CCN 341002 Federally qualified health center Operational/Managerial Control Jul 2, 2012
Rural Health Group at Halifax Community CollegeWeldon, NC, CCN 341092 Federally qualified health center Operational/Managerial Control Feb 13, 2018
Rural Health Group at Drugco ExpressRoanoke Rapids, NC, CCN 341091 Federally qualified health center Operational/Managerial Control Jul 17, 2018

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 68

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 68

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1598893547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278700640",
            "telephone_number": "252-536-5440",
            "fax_number": "252-536-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9409 NC HIGHWAY 305",
            "city": "JACKSON",
            "state": "NC",
            "postal_code": "278459679",
            "telephone_number": "252-536-5920",
            "fax_number": "252-534-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL HEALTH GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "LONG-GEE",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "252-536-5789"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rural Health Group at Jackson/Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, NC

Sources for this page

Verify at the official NPI Registry.