NPIMap

Organization Active NPI

Lisa Pettiford

  • Adult Care Home Facility
  • Durham, NC
National Provider Identifier
1679768766
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
032-407 Issued in NC
Legal business name
LISA PETTIFORD
Practice address
2801 Darrow Rd.
Durham, NC 27704-0335
Phone
(919) 493-2100
Fax
(919) 493-2112
NPI assigned
Sep 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Mrs. Lisa Spencer Pettiford
Title
Owner
Phone
(919) 599-3691

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 032-407 NC Primary

Addresses

Primary practice location

2801 Darrow Rd.
Durham, NC 27704-0335

Mailing address

PO Box 15535
Durham, NC 27704-0535
Phone (919) 493-2100

National Provider Directory

National Provider Directory
Tax ID family
Care Health Services22 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.

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1679768766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15535",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277040535",
            "telephone_number": "919-493-2100",
            "fax_number": "919-493-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 DARROW RD.",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277040335",
            "telephone_number": "919-493-2100",
            "fax_number": "919-493-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA PETTIFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "PETTIFORD",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "SPENCER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-599-3691",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "032-407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

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