NPIMap

Organization Active NPI

My Blue Sky PC

  • Early Intervention Provider Agency
  • Fayetteville, NC
National Provider Identifier
1992046668
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
6074 Issued in NC
Legal business name
MY BLUE SKY PC
Practice address
3419B Melrose Rd
Fayetteville, NC 28304-1608
Phone
(910) 257-2005
Fax
(910) 485-6315
NPI assigned
Mar 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Authorized official

Name
Mrs. Tammy Rozier Autry
Title
Office Administrator
Phone
(910) 257-2005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 6074 NC Primary

Addresses

Primary practice location

3419B Melrose Rd
Fayetteville, NC 28304-1608

Mailing address

3419B Melrose Rd
Fayetteville, NC 28304-1608
Phone (910) 257-2005

Other names 1

  • SANDHILLS THERAPY SOLUTIONS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
My Blue Sky PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3419B Melrose Rd
Fayetteville, NC 28304
Phone (910) 257-2005

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362528000000",
    "number": "1992046668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419B MELROSE RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283041608",
            "telephone_number": "910-257-2005",
            "fax_number": "910-485-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419B MELROSE RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283041608",
            "telephone_number": "910-257-2005",
            "fax_number": "910-485-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY BLUE SKY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-06",
        "last_updated": "2013-03-06",
        "status": "A",
        "authorized_official_last_name": "AUTRY",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "ROZIER",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "910-257-2005",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NC",
            "license": "6074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SANDHILLS THERAPY SOLUTIONS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.