NPIMap

Organization Active NPI

Opportunities Industrialization Center, Inc

Doing business as Oic Family Medical Center LTC

  • Federally Qualified Health Center (FQHC)
  • Rocky Mount, NC
National Provider Identifier
1932923950
Registry record updated Nov 15, 2024
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 LTC
Practice address
90 Guardian CT
Rocky Mount, NC 27804-3017
Phone
(252) 212-3350
Fax
(888) 980-1017
NPI assigned
Nov 15, 2024
Last updated
Nov 15, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
OPPORTUNITIES INDUSTRIALIZATION CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

90 Guardian CT
Rocky Mount, NC 27804-3017

Mailing address

PO Box 2723
Rocky Mount, NC 27802-2723
Phone (252) 212-3486

Other names 1

  • OIC FAMILY MEDICAL CENTER LTC Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160720000567 NC Part A Provider - Federally Qualified Health Center (FQHC) 3173563590 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rocky Mount, NC
O20161104000262 NC Part B Supplier - Clinic/Group Practice 3173563590 Receives reassigned benefits from 48 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rocky Mount, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932923950. Details of each certification follow.

Federally qualified health center certification: CCN 341045

Legal name
OPPORTUNITIES INDUSTRIALIZATION CENTER, INC
Doing business as
OIC FAMILY MEDICAL CENTER GUARDIAN COURT
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 20, 2016
Last certification
Jul 20, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 19, 1969 in NC
Enrollment address
90 Guardian CT
Rocky Mount, NC 27804-3017

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Opportunities Industrialization Center Inc7 organizations share this tax ID, including this one
Part of
Opportunities Industrialization Center Inc

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 15

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 W-2 Managing EmployeeDelegated Official Dec 1, 2011
Chayan Tiwari Individual Operational/Managerial Control Apr 1, 2023
Reuben Blackwell Individual Corporate OfficerCeo Sep 6, 2007
Opportunities Industrialization Center, Inc Organization, Rocky Mount, NC Non-profit Operational/Managerial Control Jan 14, 2005
Sherri Bryant Individual Operational/Managerial Control Apr 1, 2023
Samuel Dickens Individual Corporate OfficerCoo Jan 1, 2009
Mary Johnson Mann Individual Corporate Director Apr 1, 2005
Donna Johnson Individual Corporate DirectorTreasurer Apr 1, 2005
Hubert D Pope Individual Corporate DirectorBoard Member Jan 1, 2011
Andre Knight Individual Corporate DirectorBoard Member Jan 1, 2000
Doris K Thorne Individual Corporate DirectorBoard Member Jan 1, 2011
Evelyn Wilson Individual Corporate DirectorSecretary Apr 1, 2005
Leonard Tillery Individual Corporate DirectorBoard Member Jul 1, 2013
Brian Ellerby Individual Corporate OfficerIntegrated Health Services Director Jun 1, 2015

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 47

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 47

NPI Registry JSON

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

{
    "created_epoch": "1731628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1932923950",
    "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": "252-212-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 GUARDIAN CT",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278043017",
            "telephone_number": "252-212-3350",
            "fax_number": "888-980-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPPORTUNITIES INDUSTRIALIZATION CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPPORTUNITIES INDUSTRIALIZATION CENTER, INC",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "MONK-JONES",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "252-212-3486"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OIC FAMILY MEDICAL CENTER LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.