Organization Active NPI

Grantham Family Care Home 1

  • Health Service Clinic/Center
  • Goldsboro, NC
National Provider Identifier
1942484357
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
FCL096018 Issued in NC
Legal business name
GRANTHAM FAMILY CARE HOME 1
Practice address
642 Ditchbank Rd
Goldsboro, NC 27534-4842
Phone
(919) 734-1848
NPI assigned
Dec 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Authorized official

Name
Mrs. Elizabeth E Grantham
Title
Owner
Phone
(919) 734-1848

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X FCL096018 NC Primary

Addresses

Primary practice location

642 Ditchbank Rd
Goldsboro, NC 27534-4842

Mailing address

301 South John St
Goldsboro, NC 27530-4842
Phone (919) 734-1848

Other identifiers 1

IdentifierTypeStateIssuer
7803932MedicaidNC

National Provider Directory

National Provider Directory

Locations

642 Ditchbank Rd
Goldsboro, NC 27534
Phone (919) 734-1848

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1942484357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SOUTH JOHN ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275304842",
            "telephone_number": "919-734-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 DITCHBANK RD",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275344842",
            "telephone_number": "919-734-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANTHAM FAMILY CARE HOME 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "GRANTHAM",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-734-1848",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NC",
            "license": "FCL096018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803932",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.