NPIMap

Organization Active NPI

Carolina Health Clinic

  • Family Medicine Physician
  • Durham, NC
National Provider Identifier
1750923215
Registry record updated Oct 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CAROLINA HEALTH CLINIC
Practice address
2634 Durham Chapel Hill Blvd Ste 216
Durham, NC 27707-2800
Phone
(984) 244-7513
NPI assigned
Oct 16, 2019
Last updated
Oct 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2019

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

Authorized official

Name
Latoshia Ihenyen
Title
Administrator
Phone
(919) 282-4829

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

2634 Durham Chapel Hill Blvd Ste 216
Durham, NC 27707-2800

Mailing address

2634 Durham Chapel Hill Blvd Ste 216
Durham, NC 27707-2800
Phone (984) 244-7513

Other identifiers 1

IdentifierTypeStateIssuer
8939668MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571443200000",
    "number": "1750923215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2634 DURHAM CHAPEL HILL BLVD STE 216",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072800",
            "telephone_number": "984-244-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2634 DURHAM CHAPEL HILL BLVD STE 216",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072800",
            "telephone_number": "984-244-7513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-19",
        "status": "A",
        "authorized_official_last_name": "IHENYEN",
        "authorized_official_first_name": "LATOSHIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-282-4829"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8939668",
            "state": "NC"
        }
    ],
    "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 Oct 19, 2019; 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.