NPIMap

Organization Active NPI

Systemic Health Resources, Inc.

  • Marriage & Family Therapist
  • Raleigh, NC
National Provider Identifier
1861522138
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1092 Issued in NC
Legal business name
SYSTEMIC HEALTH RESOURCES, INC.
Practice address
1100 Logger CT
G-103
Raleigh, NC 27609-8525
Phone
(800) 755-6309
Fax
(800) 755-6309
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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

Authorized official

Name
Chad JordanNPI 1568416733
Title
President
Phone
(800) 755-6309

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 1092 NC Primary

Addresses

Primary practice location

1100 Logger CT
G-103
Raleigh, NC 27609-8525

Mailing address

PO Box 99281
Raleigh, NC 27624-9281
Phone (800) 755-6309

Other identifiers 4

IdentifierTypeStateIssuer
017UGOtherNCBCBS GROUP
6006120MedicaidNC
6006121MedicaidNC
406952OtherNCMHN

National Provider Directory

National Provider Directory

Locations

1100 Logger Ct
Ste G103
Raleigh, NC 27609
Phone (800) 755-6309

1100 Logger Ct
Ste A103
Raleigh, NC 27609
Phone (800) 755-6309

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244592000000",
    "number": "1861522138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99281",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276249281",
            "telephone_number": "800-755-6309",
            "fax_number": "800-755-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LOGGER CT",
            "address_2": "G-103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276098525",
            "telephone_number": "800-755-6309",
            "fax_number": "800-755-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYSTEMIC HEALTH RESOURCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2009-06-10",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-755-6309"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "017UG",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006120",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006121",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "406952",
            "state": "NC"
        }
    ],
    "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 Jun 10, 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.