NPIMap

Organization Active NPI

Footprints Carolina, Inc

  • Case Management Agency
  • Lincolnton, NC
National Provider Identifier
1609057165
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
FOOTPRINTS CAROLINA, INC
Practice address
311 McBee St
Lincolnton, NC 28092-2818
Phone
(704) 735-5633
Fax
(704) 735-1924
NPI assigned
Nov 26, 2007
Last updated
Dec 3, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Authorized official

Name
Mr. Richard Anderson, BS
Title
Ceo
Phone
(704) 884-2500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

311 McBee St
Lincolnton, NC 28092-2818

Mailing address

2020 Remount Rd
Gastonia, NC 28054-7476
Phone (704) 884-2500

Other identifiers 6

IdentifierTypeStateIssuer
5903099MedicaidNC
8300450HMedicaidNC
8300450MedicaidNC
8300450BMedicaidNC
6005759MedicaidNC
8300450GMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Footprints Carolina 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": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1609057165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 REMOUNT RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547476",
            "telephone_number": "704-884-2500",
            "fax_number": "704-524-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 MCBEE ST",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280922818",
            "telephone_number": "704-735-5633",
            "fax_number": "704-735-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTPRINTS CAROLINA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-884-2500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903099",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300450H",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300450",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300450B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005759",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300450G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.