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  7. NPI Record 1548262165

HIGHLAND HEALTH OF NORTH CAROLINA PA
Complete NPI Record 1548262165
Physical Medicine & Rehabilitation in Fayetteville, NC

NPI Status: Active since August 12, 2005

Contact Information

2930 VILLAGE DR
FAYETTEVILLE, NC
ZIP 28304
Phone: (910) 323-9010
Fax: (910) 323-9568

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider Business Mailing Address Fax Number
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Business Practice Location Address Fax Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Authorized Official Last Name
  22. Authorized Official First Name
  23. Authorized Official Title or Position
  24. Authorized Official Telephone Number
  25. Healthcare Provider Taxonomy Code 1
  26. Healthcare Provider Primary Taxonomy Switch 1
  27. Other Provider Identifier 1
  28. Other Provider Identifier Type Code 1
  29. Other Provider Identifier State 1
  30. Other Provider Identifier 2
  31. Other Provider Identifier Type Code 2
  32. Other Provider Identifier State 2
  33. Other Provider Identifier Issuer 2
  34. Other Provider Identifier 3
  35. Other Provider Identifier Type Code 3
  36. Other Provider Identifier State 3
  37. Other Provider Identifier Issuer 3
  38. Is Organization Subpart
  39. Authorized Official Name Prefix Text
  40. Authorized Official Credential Text
  41. Healthcare Provider Taxonomy Group 1
  42. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1548262165. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1548262165
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Entity Type Code: 2
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Employer Identification Number EIN: UNAVAIL
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Mailing Address: 2930 VILLAGE DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Mailing Address City Name: FAYETTEVILLE
The city name in the location address of the provider being identified.
Provider Business Mailing Address State Name: NC
The State code in the location of the provider being identified.
Provider Business Mailing Address Postal Code: 283043815
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Mailing Address Telephone Number: 9103239010
The telephone number associated with the location address of the provider being identified.
Provider Business Mailing Address Fax Number: 9103239568
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 2930 VILLAGE DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: FAYETTEVILLE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NC
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 283043815
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9103239010
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 9103239568
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 8/12/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 1/17/2024
The date that a record was last updated or changed.
Authorized Official Last Name: WALSH
Authorized Official First Name: ZANE
Authorized Official Title or Position: MEDICAL DIRECTOR
Authorized Official Telephone Number: 9103239010
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 208100000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: 890121J
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: NC
Other Provider Identifier 2: 0121J
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2: NC
Other Provider Identifier Issuer 2: BCBS GROUP NUMBER
Other Provider Identifier 3: CM2444
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 3: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3: NC
Other Provider Identifier Issuer 3: RAILROAD MEDICARE
Is Organization Subpart: N
Authorized Official Name Prefix Text: DR.
Authorized Official Credential Text: M.D.
Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP
NPI Certification Date: 1/17/2024