NPIMap

Organization Active NPI

Supplemental Health Care

  • Occupational Therapy Assistant
  • Raleigh, NC
National Provider Identifier
1679851356
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
0542 Issued in NC
Legal business name
SUPPLEMENTAL HEALTH CARE
Practice address
2626 Glenwood Ave
Suite 160
Raleigh, NC 27608-1043
Phone
(919) 781-9565
Fax
(919) 781-9564
NPI assigned
Jul 28, 2011
Last updated
Jul 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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

Authorized official

Name
Ms. Emily Dnistran
Title
Senior Staffing Manager
Phone
(919) 781-9565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 0542 NC Primary

Addresses

Primary practice location

2626 Glenwood Ave
Suite 160
Raleigh, NC 27608-1043

Mailing address

2626 Glenwood Ave
Suite 160
Raleigh, NC 27608-1043
Phone (919) 781-9564

National Provider Directory

National Provider Directory
Tax ID family
Supplemental Healthcare42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

Locations

2626 Glenwood Ave
Ste 160
Raleigh, NC 27608
Phone (877) 781-9565

NPI Registry JSON

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

{
    "created_epoch": "1311811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311811200000",
    "number": "1679851356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 GLENWOOD AVE",
            "address_2": "SUITE 160",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276081043",
            "telephone_number": "919-781-9564",
            "fax_number": "919-781-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 GLENWOOD AVE",
            "address_2": "SUITE 160",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276081043",
            "telephone_number": "919-781-9565",
            "fax_number": "919-781-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPLEMENTAL HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-28",
        "last_updated": "2011-07-28",
        "status": "A",
        "authorized_official_last_name": "DNISTRAN",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "SENIOR STAFFING MANAGER",
        "authorized_official_telephone_number": "919-781-9565",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NC",
            "license": "0542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2011; 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.