Active NPI
Professonal Family Health Service
- Nursing Facility/Intermediate Care Facility
- Murfreesboro, NC
National Provider Identifier
1871613299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- HC2949
- Legal business name
- PROFESSONAL FAMILY HEALTH SERVICE
- Practice address
- 130 Spring Branch Rd
Murfreesboro, NC 27855-9577 - Phone
- (252) 398-3350
- NPI assigned
- Mar 30, 2007
- Last updated
- Aug 22, 2020
- 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
- Mrs. Shaleacca Reshaun Vaughan
- Title
- President
- Phone
- (252) 398-3350
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | HC2949 | NC | Primary |
Addresses
Primary practice location
130 Spring Branch Rd
Murfreesboro, NC 27855-9577
Mailing address
PO Box 111
Murfreesboro, NC 27855-0111
Phone (252) 398-3350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6601250 | Medicaid | NC |
National Provider Directory
National Provider Directory- Tax ID family
- Professional Family Health Service
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Ahoskie, NC
- NPI 1477782159
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1871613299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 111",
"city": "MURFREESBORO",
"state": "NC",
"postal_code": "278550111",
"telephone_number": "252-398-3350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 SPRING BRANCH RD",
"city": "MURFREESBORO",
"state": "NC",
"postal_code": "278559577",
"telephone_number": "252-398-3350"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROFESSONAL FAMILY HEALTH SERVICE",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-30",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "VAUGHAN",
"authorized_official_first_name": "SHALEACCA",
"authorized_official_middle_name": "RESHAUN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "252-398-3350",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "NC",
"license": "HC2949",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6601250",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Murfreesboro, NC
- Northeasterneconomicempowermentcorporation
- Pear Tree Peace Community Economic Development Corporation
- Judith W Perry, FNP
- Lindsey Dale Phelps-Copeland, LCSW
- Diane T Prince
- Renal Treatment Centers Mid Atlantic Inc (Roanoke-Chowan Dialysis)
- Roanoke Chowan Community Health Center Inc (Hertford County Student Wellness Center)
- Roanoke Chowan Community Health Center Inc (Murfreesboro Primary Care)
- Sarah Beatrice Robinson
- Fany Michelle Sanchez Cisneros, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.