NPIMap

Organization Active NPI

Robeson Health Care Corporation

  • Community/Behavioral Health Agency
  • Lumberton, NC
National Provider Identifier
1669514683
Registry record updated Jun 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL-078-111 Issued in NC
Legal business name
ROBESON HEALTH CARE CORPORATION
Practice address
3750 Meadow View Rd
Apt. a-1
Lumberton, NC 28358-1920
Phone
(910) 618-9912
Fax
(910) 618-0728
NPI assigned
Feb 13, 2007
Last updated
Jun 28, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2017

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

Authorized official

Name
Mr. Tim Hall, M.DIV.
Title
VP/Chief of Behavioral Health SVCS
Phone
(910) 521-2900

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X MHL-078-111 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X MHL-078-111 NC
Community/Behavioral Health Agency 251S00000X MHL-078-111 NC Primary

Addresses

Primary practice location

3750 Meadow View Rd
Apt. a-1
Lumberton, NC 28358-1920

Mailing address

60 Commerce Plaza
Pembroke, NC 28372-2590
Phone (910) 521-2900

Other identifiers 6

IdentifierTypeStateIssuer
8300802PMedicaidNC
6005786MedicaidNC
8300802BMedicaidNC
8300802GMedicaidNC
8300802QMedicaidNC
8300802MedicaidNC

Other names 1

  • Grace Court Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031231000292 NC Part B Supplier - Clinic/Group Practice 1850290693 Receives reassigned benefits from 27 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Red Springs, NC; Smithfield, NC; Saint Pauls, NC; Pembroke, NC; Maxton, NC; Lumberton, NC; Fairmont, NC; Laurinburg, NC…

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Robeson Health Care Corporation16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

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": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498608000000",
    "number": "1669514683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 COMMERCE PLAZA",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283722590",
            "telephone_number": "910-521-2900",
            "fax_number": "910-775-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 MEADOW VIEW RD",
            "address_2": "APT. A-1",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283581920",
            "telephone_number": "910-618-9912",
            "fax_number": "910-618-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBESON HEALTH CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2017-06-28",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "VP/CHIEF OF BEHAVIORAL HEALTH SVCS",
        "authorized_official_telephone_number": "910-521-2900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.DIV."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": "MHL-078-111",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "MHL-078-111",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-078-111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300802P",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005786",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300802B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300802G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300802Q",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300802",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Court",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.