NPIMap

Organization Active NPI

Autumn Corporation

Doing business as Autumn Care of Forest City

  • Custodial Care Facility
  • Rocky Mount, NC
National Provider Identifier
1942467964
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
License
NH0474 Issued in NC
Legal business name
AUTUMN CORPORATION
Doing business as
Autumn Care of Forest City
Practice address
451 N Winstead Ave
Rocky Mount, NC 27804-2230
Phone
(252) 443-6265
Fax
(252) 443-2703
NPI assigned
May 19, 2008
Last updated
May 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Authorized official

Name
Mr. Sam M Marsh, CPA
Title
Vice President
Phone
(252) 443-6265

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Custodial Care Facility 311Z00000X NH0474 NC Primary

Addresses

Primary practice location

451 N Winstead Ave
Rocky Mount, NC 27804-2230

Mailing address

PO Box 7728
Rocky Mount, NC 27804-0728
Phone (252) 443-6265

Other identifiers 1

IdentifierTypeStateIssuer
7803873MedicaidNC

Other names 1

  • Autumn Care of Forest City Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Autumn Corporation39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

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

View all 38

Locations

451 N Winstead Ave
Rocky Mount, NC 27804
Phone (252) 443-6265

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1942467964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7728",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040728",
            "telephone_number": "252-443-6265",
            "fax_number": "252-443-2703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 N WINSTEAD AVE",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042230",
            "telephone_number": "252-443-6265",
            "fax_number": "252-443-2703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTUMN CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "MARSH",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "252-443-6265",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "NC",
            "license": "NH0474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803873",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Care of Forest City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.