Bobby McRae

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

320600000 Issued in NU

Practice address

299 Thomasville CH.Rd.
Mt Gilead, NC 27306

Phone

(704) 961-6797

NPI assigned

Oct 15, 2014

Last updated

Oct 15, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Facilities

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Mount Gilead, NC
  • NPI 1548694730
  NPD (past) Authorized official

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413331200000",
    "number": "1659775989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2542",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280022542",
            "telephone_number": "704-961-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 THOMASVILLE CH.RD.",
            "city": "MT GILEAD",
            "state": "NC",
            "postal_code": "27306",
            "telephone_number": "704-961-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCRAE",
        "first_name": "BOBBY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-15",
        "last_updated": "2014-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": "320600000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison K Little, PA
• Ursula Nichole Little, RN
• Lolasafehaventt@Gmail.Com
• Johnny L. McKinnon Jr., DDS
• MCPC-8, LLC (FirstHealth Convenient Care - Lake Tillery)
• Moderate Living for the Aging Inc (Mt. Gilead Independent Senior and Assisted Living)
• Monarch
• Monarch
• Mount Gilead LLC
• Mount Gilead LLC (Cochrane Ridenhour Drug Co #3)

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Mount Gilead, NC
• Providers in Mount Gilead, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.