PHP of NC, Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

MHL-032-255 Issued in NC

Legal business name

PHP OF NC, INC

Practice address

4125 Ben Franklin Blvd
Suite 180
Durham, NC 27704-2167

Phone

(919) 220-0021

Fax

(919) 220-4555

NPI assigned

Aug 29, 2006

Last updated

May 10, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justine Wiggins

Title

Executive Director

Phone

(919) 220-0021

Specialties & licenses 8

Addresses

Other identifiers 2

Tax ID family

Athens Place6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

• Athens Place

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Durham, NC
  • NPI 1184016636
  NPD tax ID
• Nixon House

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Durham, NC
  • NPI 1891127437
  NPD tax ID
• PHP of NC,Inc

  • Developmentally Disabled Services Day Training Agency
  • Zebulon, NC
  • NPI 1932531720
  NPD tax ID
• Sherman House

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Durham, NC
  • NPI 1649602079
  NPD tax ID
• Winburn House

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Durham, NC
  • NPI 1003248568
  NPD tax ID

Locations

Subparts reporting this organization as parent 5

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Athens Place

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Durham, NC
  • NPI 1184016636
  NPPES parent name
• Nixon House

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Durham, NC
  • NPI 1891127437
  NPPES parent name
• PHP of NC,Inc

  • Developmentally Disabled Services Day Training Agency
  • Zebulon, NC
  • NPI 1932531720
  NPPES parent name
• Sherman House

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Durham, NC
  • NPI 1649602079
  NPPES parent name
• Winburn House

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Durham, NC
  • NPI 1003248568
  NPPES parent name

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1679682421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20014",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277070027",
            "telephone_number": "919-220-0021",
            "fax_number": "919-220-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 BEN FRANKLIN BLVD",
            "address_2": "SUITE 180",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042167",
            "telephone_number": "919-220-0021",
            "fax_number": "919-220-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHP OF NC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "WIGGINS",
        "authorized_official_first_name": "JUSTINE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-220-0021"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NC",
            "license": "MHL-032-255",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC1631",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-032-149",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-032-245",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-032-133",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-032-349",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "MHL-032-255",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-0320255",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408783",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600586",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shauna Marie Phillips, CCC-SLP
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• Tyler Phinizy, DPT
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• PHS
• Ghee Chee Phua, MD
• Physical Recovery, LLC
• Physical Therapy of North Carolina, LLC
• Physician Assisted Wellness, PLLC

• Developmentally Disabled Services Day Training Agency in Durham, NC
• Providers in Durham, NC by specialty
• Developmentally Disabled Services Day Training Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; 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.