Opportunities Industrialization Center, Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Rocky Mount, NC
NPI 1922020908 · NPPES record last updated Mar 29, 2022
Key facts
- NPI
- 1922020908
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- OPPORTUNITIES INDUSTRIALIZATION CENTER, INC
- Practice address
- 111 S Fairview Rd
Rocky Mount, NC 27801-6971 - Phone
- (252) 446-3333
- Fax
- (252) 212-3497
- NPI assigned
- Jul 25, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- OPPORTUNITIES INDUSTRIALIZATION CENTER, INC
Authorized official
- Name
- Shirley Monk-Jones
- Title
- Billing Manager
- Phone
- (252) 212-3486
Owned or controlled facilities with NPI records 6
Other NPIs with the same Medicare PAC ID 5
Practitioners 31
-
Earic Ramon Bonner, M.D.
-
Joy Hinnant, FNP-C
-
Yolonda D Webb, M.D.
-
Olivia Talarico, PA
-
Karen B Brown, FNP-BC
-
Davneatra Foster Campbell, MSW, LCSW
-
Theodora Desronvil, FNP-BC
-
Erin Graney, MSW, LCSW
-
Lisa Renee Green, DNP, PMHNP
-
Tonya Denise Hasty, FNP-C
-
Evelyn Rudo Majachani, PMHNP
-
Tina Nnenna Ohuche, PMHNP
-
Maisha Pesante, MD
-
Glenda Pulliam, A-GNP
-
Patti Greening Sperling, FNP-C
-
Tiffany Deshelia Tyson, DNP, FNP-C, PMHNP-BC
-
Elia Xiomara Cabrera, PA-C
-
Amanpreet Singh Dhaliwal, PA-C
-
Michelle D Highsmith, PMHNP-BC
-
Emily Maye Knight, PA-C
-
Rahwa T Sebhatu, PA-C
-
Benessa Mitchell Sutton, AGNP-C
-
Tisa O Roberts, MD
-
Bianca Wright, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC
Federally qualified health center certification: CCN 341926
- Legal name
- OPPORTUNITIES INDUSTRIALIZATION CENTER, INC
- Doing business as
- OIC FAMILY MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 3, 2008
- Last certification
- Mar 3, 2008
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Aug 19, 1969 in NC
- Enrollment address
- 111 S Fairview Rd
Rocky Mount, NC 27801-6971
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Brenda F Cutchin |
Corporate Director |
Jul 1, 2013 | |
| Shirley Monk-Jones |
Operational/Managerial Control |
Apr 1, 2023 | |
| Chayan Tiwari |
Operational/Managerial Control |
Apr 1, 2023 | |
| Reuben Blackwell |
Corporate Officer |
Sep 6, 2007 | |
| Operational/Managerial Control |
Sep 6, 2007 | ||
| Sherri Bryant |
Operational/Managerial Control |
Apr 1, 2023 | |
| Samuel Dickens |
Corporate Officer |
Jan 1, 2009 | |
| Mary Johnson Mann |
Corporate Director |
Apr 1, 2005 | |
| Donna Johnson |
Corporate Director |
Apr 1, 2005 | |
| Andre Knight |
Corporate Director |
Jan 1, 2000 | |
| Doris K Thorne |
Corporate Director |
Jan 1, 2011 | |
| Evelyn Wilson |
Corporate Director |
Apr 1, 2005 | |
| Leonard Tillery |
Corporate Director |
Jul 1, 2013 |
All facility ownership & control disclosures 5
| Facility | Type | Role | Since |
|---|---|---|---|
| Oic Family Medical Center at Happy Hill |
Federally qualified health center | Operational/Managerial Control | Jan 14, 2005 |
| Oic Family Medical Center Guardian Court |
Federally qualified health center | Operational/Managerial Control | Jan 14, 2005 |
| Oic Family Medical Center at Community Health Plaza |
Federally qualified health center | Operational/Managerial Control | Jan 14, 2005 |
| Oic Specialty Care Center |
Federally qualified health center | Operational/Managerial Control | Mar 3, 2008 |
| Oic Sunset Avenue |
Federally qualified health center | Operational/Managerial Control | Jun 28, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050505000237 | NC | Part B Supplier - Clinic/Group Practice | 3173563590 |
Receives reassigned benefits from 22 practitioners Practice locations: Rocky Mount, NC |
| O20070925000122 | NC | Part a Provider - Federally Qualified Health Center (FQHC) | 3173563590 | Practice locations: Rocky Mount, NC |
National Provider Directory
- Part of
- Rocky Mount Oic Family Medical Center
Locations
9918 Katella Ave
Ste Ac
Anaheim, CA 92804
Phone (714) 644-9494
801 Williford St
Rocky Mount, NC 27803
Phone (252) 212-3350
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | NC | Yes |
Addresses
Primary practice location
111 S Fairview Rd
Rocky Mount, NC 27801-6971
Mailing address
PO Box 2723
Rocky Mount, NC 27802-2723
Phone (252) 212-6802
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 344004A | Medicaid | NC |
Other names
- OIC Family Medical Center
Other providers in Rocky Mount, NC
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All providers in Rocky Mount, NC · Federally Qualified Health Center (FQHC) in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.