NPIMap

Organization Active NPI

Footprints Carolina, Inc

  • Case Management Agency
  • Gastonia, NC
National Provider Identifier
1649387200
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
FOOTPRINTS CAROLINA, INC
Practice address
2020 Remount Rd
Gastonia, NC 28054-7437
Phone
(704) 524-2009
Fax
(704) 524-2095
NPI assigned
Aug 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Authorized official

Name
Richard Anderson Sr.
Title
Executive Director
Phone
(704) 884-2500

Specialties & licenses 2

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

Addresses

Primary practice location

2020 Remount Rd
Gastonia, NC 28054-7437

Mailing address

5700 Executive Center Dr Ste 100
Charlotte, NC 28212-8833
Phone (704) 566-3460

Other identifiers 1

IdentifierTypeStateIssuer
6005997MedicaidNC

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.

Locations

5700 Executive Center Dr
Ste 100
Charlotte, NC 28212
Phone (704) 207-0995

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260230400000",
    "number": "1649387200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 EXECUTIVE CENTER DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128833",
            "telephone_number": "704-566-3460",
            "fax_number": "704-566-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 REMOUNT RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547437",
            "telephone_number": "704-524-2009",
            "fax_number": "704-524-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTPRINTS CAROLINA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2009-12-08",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-884-2500",
        "authorized_official_name_suffix": "Sr."
    },
    "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": "6005997",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; 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.