Snapback NC, Co.

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Legal business name

SNAPBACK NC, CO.

Practice address

703 N Broad St
Edenton, NC 27932-1430

Phone

(252) 698-1389

NPI assigned

Dec 12, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Courtney Layne Butler, NCCPSSNPI 1356052203

Title

President

Phone

(252) 260-9406

Specialties & licenses 3

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Courtney Layne Butler, NCCPSS

  • Peer Specialist
  • Edenton, NC
  • NPI 1356052203
  NPD Authorized official
• Carolyn L Bassett, NCCPSS

  • Peer Specialist
  • Edenton, NC
  • NPI 1013620855
  NPD

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1851002794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 N BROAD ST",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279321430",
            "telephone_number": "252-698-1389",
            "fax_number": "252-368-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N BROAD ST",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279321430",
            "telephone_number": "252-698-1389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNAPBACK NC, CO.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-12",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "LAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-260-9406",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NCCPSS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lonnie V Sieck, DDS
• Jori Sienkiewicz, PT
• Laurie Halsey Simmons, LCSW
• Christopher Dewaine Smith, DC
• Susan Loraine Smoots, FNP
• Marvin Nelson Spear, PHARMD
• Jessica Spruill, PTA
• Sierra Swain, LCSW-A
• Robert Nathan Sykes Jr., PHARMACIST
• Tar River LTC Group, LLC (Chowan River Nursing and Rehabilitation Center)

• Peer Specialist in Edenton, NC
• Providers in Edenton, NC by specialty
• Peer Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; 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.