NPIMap

Organization Active NPI

Surry County Health and Nutrition Center

  • Home Health Agency
  • Mount Airy, NC
National Provider Identifier
1609928894
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SURRY COUNTY HEALTH AND NUTRITION CENTER
Practice address
1218 State St
Suite 200
Mount Airy, NC 27030-5001
Phone
(336) 783-8500
Fax
(336) 783-8525
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Cindy Nicole Simmons
Title
Office Manager
Phone
(336) 783-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1218 State St
Suite 200
Mount Airy, NC 27030-5001

Mailing address

1218 State St
Suite 200
Mount Airy, NC 27030-5001
Phone (336) 783-8500

Other identifiers 1

IdentifierTypeStateIssuer
6600412MedicaidNC

Other names 1

  • Surry County Friends of Seniors Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Surry County Convalescent Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609928894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 STATE ST",
            "address_2": "SUITE 200",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305001",
            "telephone_number": "336-783-8500",
            "fax_number": "336-783-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 STATE ST",
            "address_2": "SUITE 200",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305001",
            "telephone_number": "336-783-8500",
            "fax_number": "336-783-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURRY COUNTY HEALTH AND NUTRITION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "336-783-8500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600412",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surry County Friends of Seniors",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Airy, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.