DOROTHEA DIX HOSPITAL (NPI# 1073651733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073651733 |
| Entity Type | Organization |
| Organization Name | DOROTHEA DIX HOSPITAL |
| Other Organization Name | CENTRAL REGIONAL HOSPITAL |
| Practice Address |
820 S Boylan Ave Raleigh NC 27603-2246 |
| Mailing Address |
820 S Boylan Ave 3601 Mail Service Center Raleigh NC 27603-2246 |
| Practice Telephone | 9197335540 |
| Practice Fax Number | 9197330743 |
| Mailing Telephone | 9197335540 |
| Mailing Fax Number | 9197330743 |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2010-08-18 |
| Authorized Official Name | MR. J. LUCKEY WELSH JR. (DIRECTOR -DSOHF) |
| Authorized Official Telephone | 9198554700 |
| Authorized Official Credential | FACHE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3404001 | 05 |
| Other Name | Type Code |
|---|---|
| Central Regional Hospital | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316164254 | Dorothea Dix Hospital | General Acute Care Hospital | 820 S Boylan Ave, Raleigh, NC 27603-2246 | 2007-04-20 |
| 1053450049 | Dorothea Dix Hospital | Pharmacy | 820 S Boylan Avenue, Raleigh, NC 27603 | 2007-02-06 |
| 1265571277 | Dorothea Dix Hospital | Psychiatric Residential Treatment Facility | 820 S Boylan Ave, Raleigh, NC 27603-2246 | 2007-02-06 |
| 1982764825 | Dorothea Dix Hospital | Clinic/Center | 820 S Boylan Ave, Raleigh, NC 27603-2246 | 2006-12-11 |
| Street Address |
820 S BOYLAN AVE |
| City | RALEIGH |
| State | NC |
| Zip Code | 27603-2246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093721714 | Jacqueline Gaillard Gibson | Physician Assistant | 820 S Boylan Ave, Raleigh, NC 27603-2246 | 2006-08-01 |
| 1477870608 | Elizabeth F Lansing | Social Worker | 820 S Boylan Ave, Raleigh, NC 27603-2246 | 2010-04-28 |
| 1972745453 | George Timothy Dennard | Social Worker | 820 S Boylan Ave, Raleigh, NC 27603-2246 | 2009-03-31 |
| 1306085212 | Gordon Kyle Lavin | Psychiatry & Neurology | 820 S Boylan Ave, 2 East, Raleigh, NC 27603-2246 | 2009-02-17 |
| 1275742579 | Thomas Matthews Haizlip | Psychiatry & Neurology | 820 S Boylan Ave, Scott Building, Raleigh, NC 27603-2246 | 2007-05-22 |
| 1760690705 | Tanya Rose Cheevers | Psychiatry & Neurology | 820 S Boylan Ave, Mcbryde Bldg., Raleigh, NC 27603-2246 | 2007-05-21 |
| 1740498286 | Judy Neal Bennett | Pharmacist | 820 S Boylan Ave, Raleigh, NC 27603-2246 | 2007-05-18 |
| 1124246111 | Nicole Francoise Wolfe | Psychiatry & Neurology | 820 S Boylan Ave, Raleigh, NC 27603-2246 | 2007-04-23 |
| 1316164254 | Dorothea Dix Hospital | General Acute Care Hospital | 820 S Boylan Ave, Raleigh, NC 27603-2246 | 2007-04-20 |
| 1861526113 | James Kraig Dixon | Social Worker | 820 S Boylan Ave, Raleigh, NC 27699-0001 | 2007-03-16 |
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|---|---|---|---|---|
| 1245854736 | Rdu Medical Transportation Group | Non-emergency Medical Transport (VAN) | 3751 Junction Blvd Suite C Raleigh Nc 27603, C, Raleigh, NC 27603 | 2020-06-01 |
| 1275997595 | Run Raleigh Pt, LLC | Physical Therapist | 401 N West Street, Suite 121, Raleigh, NC 27603 | 2016-04-12 |
| 1508256496 | Nneka Ifeoma Hay | Nurse Practitioner | 1390 Capital Boulevard, Raleigh, NC 27603 | 2015-01-29 |
| 1841680220 | Oswald H Ganley | Internal Medicine | 1251 Goode St, The Healing Place of Wake County, Raleigh, NC 27603 | 2015-01-23 |
| 1578979548 | Grishma Ajmera | Pharmacist | 1531 Dormitory Rd, Raleigh, NC 27603 | 2014-07-10 |
| 1699036467 | Brian Ellison | Pharmacist | 401 Glenwood Ave # 101, Raleigh, NC 27603 | 2012-06-07 |
| 1255607610 | Brian Nichols | Specialist/Technologist | 605 Trunecek Circle, Raleigh, NC 27603 | 2012-03-29 |
| 1548532120 | Living With Autism Inc | Home Health | 7401 Denlee Rd, Raleigh, NC 27603 | 2012-01-30 |
| 1417238189 | Crystal Shawnette Yarborough | Counselor | 3040 Hammond Business Pl Suite 105, Va Raleigh II Clinic, Raleigh, NC 27603 | 2011-09-07 |
| 1982906673 | Annie & Khamorah's Place | Home Health | 2917 Fairway Drive, Raleigh, NC 27603 | 2010-12-01 |
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| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
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| 1023122462 | Jafar Nosrat Ghassemian | Psychiatric Hospital | 820 S Boylan Ave, Raleigh, NC 27699-0001 | 2006-08-19 |
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| 1295938652 | Linda Ruth Derbes | Psychiatric Hospital | 4919 S Miami Blvd, Durham, NC 27703-8435 | 2007-06-06 |
| 1992851331 | Julian F Keith Alcohol and Drug Abuse Treatment Center | Psychiatric Hospital | 201 Tabernacle Road, Black Mountain, NC 28711 | 2007-01-26 |
| 1891889465 | Sally Louise Walker | Psychiatric Hospital | 1003 12 Street, Butner, NC 27509 | 2006-10-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.