Healthcare Provider Details

I. General information

NPI: 1972194868
Provider Name (Legal Business Name): GENERATIONS FAMILY PRACTICE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2021
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 ENGLISH RD STE 100
ROCKY MOUNT NC
27804-6027
US

IV. Provider business mailing address

804 ENGLISH RD STE 100
ROCKY MOUNT NC
27804-6027
US

V. Phone/Fax

Practice location:
  • Phone: 252-443-3133
  • Fax: 252-443-6726
Mailing address:
  • Phone: 252-443-3133
  • Fax: 252-443-6726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN GENNA ONEILL
Title or Position: PROVIDER CREDENTIALING SPECIALIST
Credential:
Phone: 919-439-8108