Avaya Health Services, LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

AVAYA HEALTH SERVICES, LLC

Practice address

4921 Albemarle Rd
Suite 111
Charlotte, NC 28205-6654

Phone

(919) 454-1672

NPI assigned

Jul 30, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Dwayne Gray

Title

Ceo/Executive Director

Phone

(919) 454-1672

Specialties & licenses 1

Addresses

Other names 1

• Avaya Health Services, LLC - SC Doing business as

Tax ID family

Avaya Health Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Avaya Health Services, LLC

  • Exclusive Provider Organization
  • Durham, NC
  • NPI 1609133693
  NPD tax ID

Locations

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406678400000",
    "number": "1649688953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6409 FAYETTEVILLE RD",
            "address_2": "SUITE 120-302",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136297",
            "telephone_number": "919-454-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 ALBEMARLE RD",
            "address_2": "SUITE 111",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056654",
            "telephone_number": "919-454-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVAYA HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-30",
        "last_updated": "2014-07-30",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_title_or_position": "CEO/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-454-1672",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avaya Health Services, LLC - SC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Elissa Avalos-Beltran
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• Gabriella Avellone, MS, OTR/L
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• Avenues ABA NC LLC
• Avenues to Success, Inc.

• All providers in Charlotte, NC
• Exclusive Provider Organization in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; 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.