NPIMap

Organization Active NPI

Elderhaus, Inc

  • PACE Provider Organization
  • Wilmington, NC
National Provider Identifier
1699983312
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
ELDERHAUS, INC
Practice address
2222 S 17TH St
Wilmington, NC 28401-7515
Phone
(910) 343-8209
Fax
(910) 343-8836
NPI assigned
May 18, 2007
Last updated
Aug 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Authorized official

Name
Ruth Finch
Title
Executive Director
Phone
(910) 343-8209

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X Primary
Adult Day Care Clinic/Center 261QA0600X NC

Addresses

Primary practice location

2222 S 17TH St
Wilmington, NC 28401-7515

Mailing address

2222 S 17TH St
Wilmington, NC 28401-7515
Phone (910) 343-8209

Other identifiers 1

IdentifierTypeStateIssuer
3408284MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Elderhaus Inc2 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.

Locations

2222 S 17th St
Wilmington, NC 28401
Phone (910) 343-8209

Ownership & related parties

Subparts reporting this organization as parent 1

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

Practitioners & affiliated clinicians

Practitioners 11

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": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1699983312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017515",
            "telephone_number": "910-343-8209",
            "fax_number": "910-343-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017515",
            "telephone_number": "910-343-8209",
            "fax_number": "910-343-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERHAUS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "FINCH",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "910-343-8209"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408284",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.