Eleventh Judicial District Reentry, Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ELEVENTH JUDICIAL DISTRICT REENTRY, INC.

Practice address

1329 N Brightleaf Blvd
Suite a-2
Smithfield, NC 27577-7262

Phone

(919) 989-7278

Fax

(919) 989-8943

NPI assigned

Mar 13, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Dot C. Ehlers

Title

Executive Director

Phone

(919) 989-7278

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881727709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1153",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275771153",
            "telephone_number": "919-989-7278",
            "fax_number": "919-989-8943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 N BRIGHTLEAF BLVD",
            "address_2": "SUITE A-2",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275777262",
            "telephone_number": "919-989-7278",
            "fax_number": "919-989-8943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVENTH JUDICIAL DISTRICT REENTRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EHLERS",
        "authorized_official_first_name": "DOT",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-989-7278",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Michael Edmundson
• Amy Elizabeth Edwards
• Carol Edwards, N.P.
• Debbie Moore Edwards
• Kimberly Edwards, RD
• Wendy Elliott, PHD
• Christopher Ellis, PHARMD
• Emergeortho, PA
• David Chandler Ennis, PT
• Theodora Erim, NCC, LCMHC, LCAS-A

• Clinical Social Worker in Smithfield, NC
• Providers in Smithfield, NC by specialty
• Clinical Social Worker in North Carolina

• 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.

Verify at the official NPI Registry.