Active NPI
Granville Health Inc
- Emergency Medicine Physician
- Creedmoor, NC
National Provider Identifier
1700858883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- GRANVILLE HEALTH INC
- Practice address
- 1614 NC Highway 56
Creedmoor, NC 27522-8297 - Phone
- (919) 528-7171
- Fax
- (919) 528-8797
- NPI assigned
- Feb 3, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cristina Blalock
- Title
- Office Manager
- Phone
- (919) 528-7171
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary |
Addresses
Primary practice location
1614 NC Highway 56
Creedmoor, NC 27522-8297
Mailing address
1614 NC Highway 56
Creedmoor, NC 27522-8297
Phone (919) 528-7171
Other names 1
- Community Immediate Care Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 2
Other NPIs on the same Medicare enrollment 13
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
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National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Smithfield, NC
- NPI 1699848945
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138924800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1252540800000",
"number": "1700858883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1614 NC HIGHWAY 56",
"city": "CREEDMOOR",
"state": "NC",
"postal_code": "275228297",
"telephone_number": "919-528-7171",
"fax_number": "919-528-8797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1614 NC HIGHWAY 56",
"city": "CREEDMOOR",
"state": "NC",
"postal_code": "275228297",
"telephone_number": "919-528-7171",
"fax_number": "919-528-8797"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRANVILLE HEALTH INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-03",
"last_updated": "2009-09-10",
"status": "A",
"authorized_official_last_name": "BLALOCK",
"authorized_official_first_name": "CRISTINA",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "919-528-7171"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Community Immediate Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Creedmoor, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.