NPIMap

Organization Active NPI

Integrated Family Services PLLC

  • Clinical Social Worker
  • Elizabeth City, NC
National Provider Identifier
1629205208
Registry record updated Nov 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
INTEGRATED FAMILY SERVICES PLLC
Practice address
110 Medical Dr Ste 5
Elizabeth City, NC 27909-3374
Phone
(252) 384-0388
Fax
(252) 384-0188
NPI assigned
Jun 22, 2009
Last updated
Nov 17, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2017

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

Authorized official

Name
Mr. Anthony Jerome Manley-Rook, LCSW
Title
Administrative Director
Phone
(252) 367-6601

Specialties & licenses 1

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

Addresses

Primary practice location

110 Medical Dr Ste 5
Elizabeth City, NC 27909-3374

Mailing address

PO Box 885
Ahoskie, NC 27910-0885
Phone (252) 862-4411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080523000513 NC Part B Supplier - Clinic/Group Practice 2567464563 Receives reassigned benefits from 14 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wilmington, NC; Jacksonville, NC; Elizabeth City, NC; Greenville, NC; Ahoskie, NC

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Integrated Family Services PLLC23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Locations

3383 Henderson Dr
Jacksonville, NC 28546
Phone (252) 567-3499

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510876800000",
    "number": "1629205208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 885",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279100885",
            "telephone_number": "252-862-4411",
            "fax_number": "252-862-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MEDICAL DR STE 5",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093374",
            "telephone_number": "252-384-0388",
            "fax_number": "252-384-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED FAMILY SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-22",
        "last_updated": "2017-11-17",
        "status": "A",
        "authorized_official_last_name": "MANLEY-ROOK",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "252-367-6601",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.