NPIMap

Organization Active NPI

Avalon # 4

  • Adult Care Home Facility
  • Raleigh, NC
National Provider Identifier
1770811804
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
AVALON # 4
Practice address
5040 Kaplan Dr
Raleigh, NC 27606-2523
Phone
(336) 253-2219
NPI assigned
Dec 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Authorized official

Name
Ijeoma Nwankwo
Title
Owner
Phone
(336) 253-2219

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X Primary

Addresses

Primary practice location

5040 Kaplan Dr
Raleigh, NC 27606-2523

Mailing address

4428 Louisburg Rd
Suite 109
Raleigh, NC 27616-4302
Phone (336) 253-2219

National Provider Directory

National Provider Directory
Tax ID family
Avalon 35 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

4428 Louisburg Rd
Ste 109
Raleigh, NC 27616
Phone (919) 272-1048

NPI Registry JSON

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259625600000",
    "number": "1770811804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4428 LOUISBURG RD",
            "address_2": "SUITE 109",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276164302",
            "telephone_number": "336-253-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 KAPLAN DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062523",
            "telephone_number": "336-253-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON # 4",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-01",
        "last_updated": "2009-12-01",
        "status": "A",
        "authorized_official_last_name": "NWANKWO",
        "authorized_official_first_name": "IJEOMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-253-2219"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "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 Dec 1, 2009; 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.