NPIMap

Organization Active NPI

Opportunities Industrialization Center, Inc

Doing business as OIC Family Medical Center

  • Federally Qualified Health Center (FQHC)
  • Rocky Mount, NC
National Provider Identifier
1922020908
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OPPORTUNITIES INDUSTRIALIZATION CENTER, INC
Doing business as
OIC Family Medical Center
Practice address
111 S Fairview Rd
Rocky Mount, NC 27801-6971
Phone
(252) 446-3333
Fax
(252) 212-3497
NPI assigned
Jul 25, 2006
Last updated
Mar 29, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
OPPORTUNITIES INDUSTRIALIZATION CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Authorized official

Name
Shirley Monk-Jones
Title
Billing Manager
Phone
(252) 212-3486

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NC Primary

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 1

IdentifierTypeStateIssuer
344004AMedicaidNC

Other names 1

  • OIC Family Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1922020908. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Aug 19, 1969 in NC
Enrollment address
111 S Fairview Rd
Rocky Mount, NC 27801-6971

Federally qualified health center certification: CCN 341018

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ROCKY MOUNT OIC FAMILY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 28, 2014
Last certification
Aug 28, 2014
Ownership / control type
For profit – corporation
Facility address
111 South Fairview Road
Rocky Mount, NC 27801

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Opportunities Industrialization Center Inc

Locations

111 S Fairview Rd
Rocky Mount, NC 27801
Phone (252) 212-3486

300 N Grace St
Rocky Mount, NC 27804
Phone (252) 210-9856

90 Guardian Ct
Rocky Mount, NC 27804
Phone (252) 212-3350

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Brenda F Cutchin Individual Corporate DirectorBoard Member Jul 1, 2013
Shirley Monk-Jones Individual Operational/Managerial ControlBilling Manager Apr 1, 2023
Chayan Tiwari Individual Operational/Managerial ControlCfo Apr 1, 2023
Reuben Blackwell Individual Corporate OfficerCeo Sep 6, 2007
Operational/Managerial ControlCeo Sep 6, 2007
Sherri Bryant Individual Operational/Managerial ControlChoo Apr 1, 2023
Samuel Dickens Individual Corporate OfficerCoo Jan 1, 2009
Mary Johnson Mann Individual Corporate DirectorBoard Member Apr 1, 2005
Donna Johnson Individual Corporate DirectorTreasurer/Board Member Apr 1, 2005
Andre Knight Individual Corporate DirectorBoard Member Jan 1, 2000
Doris K Thorne Individual Corporate DirectorBoard Member Jan 1, 2011
Evelyn Wilson Individual Corporate DirectorSecretary/Board Member Apr 1, 2005
Leonard Tillery Individual Corporate DirectorBoard Member Jul 1, 2013

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Oic Family Medical Center at Happy HillRocky Mount, NC, CCN 341023 Federally qualified health center Operational/Managerial Control Jan 14, 2005
Oic Family Medical Center Guardian CourtRocky Mount, NC, CCN 341045 Federally qualified health center Operational/Managerial Control Jan 14, 2005
Oic Family Medical Center at Community Health PlazaRocky Mount, NC, CCN 341059 Federally qualified health center Operational/Managerial Control Jan 14, 2005
Oic Specialty Care CenterRocky Mount, NC, CCN 341096 Federally qualified health center Operational/Managerial Control Mar 3, 2008
Oic Sunset AvenueRocky Mount, NC, CCN B61010 Federally qualified health center Operational/Managerial Control Jun 28, 2022

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1922020908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2723",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278022723",
            "telephone_number": "252-212-6802",
            "fax_number": "252-212-3497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S FAIRVIEW RD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278016971",
            "telephone_number": "252-446-3333",
            "fax_number": "252-212-3497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPPORTUNITIES INDUSTRIALIZATION CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPPORTUNITIES INDUSTRIALIZATION CENTER, INC",
        "enumeration_date": "2006-07-25",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "MONK-JONES",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "252-212-3486"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344004A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OIC Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OIC Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.