Active NPI
NC Dept of Military and Veterans Affairs NC Division of Veterans Affai
- Skilled Nursing Facility
- Fayetteville, NC
National Provider Identifier
1871508408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- NH0585
- Legal business name
- NC DEPT OF MILITARY AND VETERANS AFFAIRS NC DIVISION OF VETERANS AFFAI
- Practice address
- 214 Cochran Ave
Fayetteville, NC 28301-3875 - Phone
- (910) 482-4131
- NPI assigned
- Jul 30, 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
- Terry Edward Westbrook
- Title
- Director of Veterans Services
- Phone
- (984) 204-2982
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NH0585 | NC | Primary |
Addresses
Primary practice location
214 Cochran Ave
Fayetteville, NC 28301-3875
Mailing address
4001 Mail Service Ctr
Raleigh, NC 27699-4001
Phone (984) 204-2990
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0086A | Other | NC | BCBS |
| 3405492 | Medicaid | NC |
National Provider Directory
National Provider Directory- Tax ID family
- Dept of Administration Ncdva
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Salisbury, NC
- NPI 1407930936
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Skilled Nursing Facility
- Salisbury, NC
- NPI 1407930936
Member Of
Locations
214 Cochran Ave
Fayetteville, NC 28301
Phone (910) 482-4131
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154217600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1655251200000",
"number": "1871508408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 MAIL SERVICE CTR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276994001",
"telephone_number": "984-204-2990",
"fax_number": "984-204-8344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 COCHRAN AVE",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283013875",
"telephone_number": "910-482-4131"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NC DEPT OF MILITARY AND VETERANS AFFAIRS NC DIVISION OF VETERANS AFFAI",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-30",
"last_updated": "2022-06-15",
"certification_date": "2022-06-15",
"status": "A",
"authorized_official_last_name": "WESTBROOK",
"authorized_official_first_name": "TERRY",
"authorized_official_middle_name": "EDWARD",
"authorized_official_title_or_position": "DIRECTOR OF VETERANS SERVICES",
"authorized_official_telephone_number": "984-204-2982"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NC",
"license": "NH0585",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0086A",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3405492",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.