NPIMap

Organization Active NPI

Summit Support Services of Ashe, Inc

  • Developmental Disabilities Clinic/Center
  • Jefferson, NC
National Provider Identifier
1922283340
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
SUMMIT SUPPORT SERVICES OF ASHE, INC
Practice address
342 Long St
Jefferson, NC 28640-9789
Phone
(336) 846-4491
Fax
(336) 846-4927
NPI assigned
Jan 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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

Authorized official

Name
Mrs. Shari Anderson Rognstad
Title
Executive Director
Phone
(336) 846-4491

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Developmental Disabilities Clinic/Center 261QD1600X Primary
Adult Care Home Facility 311ZA0620X

Addresses

Primary practice location

342 Long St
Jefferson, NC 28640-9789

Mailing address

PO Box 381
Jefferson, NC 28640-0381
Phone (336) 846-4491

Other identifiers 1

IdentifierTypeStateIssuer
7804402MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Summit Support Services of Ashe Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511136000000",
    "number": "1922283340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "286400381",
            "telephone_number": "336-846-4491",
            "fax_number": "336-846-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 LONG ST",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "286409789",
            "telephone_number": "336-846-4491",
            "fax_number": "336-846-4927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT SUPPORT SERVICES OF ASHE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2017-11-20",
        "status": "A",
        "authorized_official_last_name": "ROGNSTAD",
        "authorized_official_first_name": "SHARI",
        "authorized_official_middle_name": "ANDERSON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-846-4491",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804402",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2017; 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.