NPIMap

Organization Active NPI

Easter Seals Ucp North Carolina & Virginia, Inc.

  • Adult Care Home Facility
  • Snow Hill, NC
National Provider Identifier
1932245040
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Practice address
704 SE 2ND St
Snow Hill, NC 28580-1631
Phone
(252) 747-3654
NPI assigned
Jan 29, 2007
Last updated
Dec 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Authorized official

Name
Jelore Little
Title
Dir, Contracts & Credentialing
Phone
(336) 545-6338

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

704 SE 2ND St
Snow Hill, NC 28580-1631

Mailing address

5171 Glenwood Ave
Suite 400
Raleigh, NC 27612-3266
Phone (919) 783-8898

Other practice location 1

116 N Cool Spring St
Fayetteville, NC 28301-5134
Phone (910) 500-6606

Other identifiers 1

IdentifierTypeStateIssuer
6600867MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Easter Seals Ucp North Carolina Virginia Inc224 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

116 N Cool Spring St
Fayetteville, NC 28301
Phone (910) 500-6606

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576800000000",
    "number": "1932245040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 GLENWOOD AVE",
            "address_2": "SUITE 400",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123266",
            "telephone_number": "919-783-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 SE 2ND ST",
            "city": "SNOW HILL",
            "state": "NC",
            "postal_code": "285801631",
            "telephone_number": "252-747-3654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 N Cool Spring St",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283015134",
            "country_code": "US",
            "telephone_number": "910-500-6606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "JELORE",
        "authorized_official_title_or_position": "DIR, CONTRACTS & CREDENTIALING",
        "authorized_official_telephone_number": "336-545-6338"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600867",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snow Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.