NPIMap

Organization Active NPI

North Carolina Support Services

  • Developmentally Disabled Services Day Training Agency
  • Statesville, NC
National Provider Identifier
1679506794
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
NORTH CAROLINA SUPPORT SERVICES
Practice address
2290 Salisbury Hwy
Statesville, NC 28677-2731
Phone
(704) 978-0010
Fax
(704) 873-3446
NPI assigned
Jul 9, 2006
Last updated
Jan 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

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

Authorized official

Name
Mr. Robert Dennis Pinkney
Title
Chief Operating Officer
Phone
(704) 978-0010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X NC Primary

Addresses

Primary practice location

2290 Salisbury Hwy
Statesville, NC 28677-2731

Mailing address

2290 Salisbury Hwy
Statesville, NC 28677-2731
Phone (704) 978-0010

Other identifiers 3

IdentifierTypeStateIssuer
8301268MedicaidNC
3409423MedicaidNC
8301268BMedicaidNC

National Provider Directory

National Provider Directory

Locations

2290 Salisbury Hwy
Statesville, NC 28677
Phone (704) 978-0010

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1679506794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 SALISBURY HWY",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286772731",
            "telephone_number": "704-978-0010",
            "fax_number": "704-873-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 SALISBURY HWY",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286772731",
            "telephone_number": "704-978-0010",
            "fax_number": "704-873-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "PINKNEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "704-978-0010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301268",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409423",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301268B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.