NPIMap

Organization Active NPI

Outlook Forensic and Behavioral Health

  • Community/Behavioral Health Agency
  • Matthews, NC
National Provider Identifier
1003248808
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
200500827 Issued in NC
Legal business name
OUTLOOK FORENSIC AND BEHAVIORAL HEALTH
Practice address
1254 Mann Dr
Suite 100
Matthews, NC 28105-5545
Phone
(704) 841-3886
Fax
(704) 841-3889
NPI assigned
Aug 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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

Authorized official

Name
Dr. Jonathan Keith Stoudmire, M.D.
Title
President
Phone
(704) 699-5296

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 200500827 NC Primary

Addresses

Primary practice location

1254 Mann Dr
Suite 100
Matthews, NC 28105-5545

Mailing address

1254 Mann Dr
Suite 100
Matthews, NC 28105-5545
Phone (704) 841-3886

Other identifiers 1

IdentifierTypeStateIssuer
5900927MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Outlook Forensic and Behavioral Health Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1254 Mann Dr
Ste 100
Matthews, NC 28105
Phone (704) 841-3886

Practitioners & affiliated clinicians

Practitioners 2

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": "1375401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375660800000",
    "number": "1003248808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1254 MANN DR",
            "address_2": "SUITE 100",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055545",
            "telephone_number": "704-841-3886",
            "fax_number": "704-841-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1254 MANN DR",
            "address_2": "SUITE 100",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055545",
            "telephone_number": "704-841-3886",
            "fax_number": "704-841-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTLOOK FORENSIC AND BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-02",
        "last_updated": "2013-08-05",
        "status": "A",
        "authorized_official_last_name": "STOUDMIRE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-699-5296",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "200500827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900927",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.