NPIMap

Organization Active NPI

Restore Healthcare

  • Case Management Registered Nurse
  • Harrisburg, NC
National Provider Identifier
1639513708
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
Legal business name
RESTORE HEALTHCARE
Practice address
4350 Main St
Suite 211
Harrisburg, NC 28075-7433
Phone
(704) 559-9408
Fax
(704) 731-0975
NPI assigned
Apr 19, 2013
Last updated
Jun 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Authorized official

Name
Chris Jarrett
Title
Executive Director
Phone
(704) 559-9408

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Renal Nutrition Registered Dietitian 133VN1005X NC
Case Management Registered Nurse 163WC0400X NC Primary
Physical Therapist 225100000X
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

4350 Main St
Suite 211
Harrisburg, NC 28075-7433

Mailing address

4258 Highway 49 S
Unit 554
Harrisburg, NC 28075-0345
Phone (704) 559-9408

Other identifiers 1

IdentifierTypeStateIssuer
REHABILITATIVEOtherNCBLUE CROSS BLUE SHIELD

Other names 1

  • Restore Healthcare Medical Group Other name

National Provider Directory

National Provider Directory
Tax ID family
Restore Healthcare4 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.

Locations

4350 Main St
Ste 211
Harrisburg, NC 28075
Phone (704) 559-9408

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435536000000",
    "number": "1639513708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4258 HIGHWAY 49 S",
            "address_2": "UNIT 554",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280750345",
            "telephone_number": "704-559-9408",
            "fax_number": "704-731-0975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 MAIN ST",
            "address_2": "SUITE 211",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280757433",
            "telephone_number": "704-559-9408",
            "fax_number": "704-731-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-19",
        "last_updated": "2015-06-29",
        "status": "A",
        "authorized_official_last_name": "JARRETT",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-559-9408"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "REHABILITATIVE",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restore Healthcare Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Harrisburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.