NPIMap

Organization Active NPI

Easter Seals Ucp North Carolina & Virginia, Inc.

  • Community/Behavioral Health Agency
  • New Bern, NC
National Provider Identifier
1013061746
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Practice address
2801 Neuse Blvd
New Bern, NC 28562-2838
Phone
(252) 636-6007
Fax
(252) 636-3732
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Authorized official

Name
Jelore Little
Title
Director, Contracts & Credentialing
Phone
(336) 545-6338

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2801 Neuse Blvd
New Bern, NC 28562-2838

Mailing address

5171 Glenwood Ave
Suite 211
Raleigh, NC 27612-3266
Phone (919) 783-8898

Other practice location 1

205 W Bayshore Blvd
Jacksonville, NC 28540-5339
Phone (910) 347-9711

Other identifiers 3

IdentifierTypeStateIssuer
8300385BMedicaidNC
8300385MedicaidNC
8300385HMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101105000534 NC Part B Supplier - Clinic/Group Practice 7618161407 Receives reassigned benefits from 79 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Raleigh, NC; Jacksonville, NC; New Bern, NC; Nags Head, NC; Mount Airy, NC; Morganton, NC; Morehead City, NC; Kinston, NC…

National Provider Directory

National Provider Directory
Tax ID family
Easter Seals Ucp North Carolina Virginia Inc224 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Locations

1722 Trent Blvd
New Bern, NC 28560
Phone (252) 631-5417

6026 Six Forks Rd
Raleigh, NC 27609
Phone (919) 865-8710

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": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1013061746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 GLENWOOD AVE",
            "address_2": "SUITE 211",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123266",
            "telephone_number": "919-783-8898",
            "fax_number": "919-782-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 NEUSE BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622838",
            "telephone_number": "252-636-6007",
            "fax_number": "252-636-3732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 W Bayshore Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285405339",
            "country_code": "US",
            "telephone_number": "910-347-9711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "JELORE",
        "authorized_official_title_or_position": "DIRECTOR, CONTRACTS & CREDENTIALING",
        "authorized_official_telephone_number": "336-545-6338"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300385B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300385",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300385H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.