NPIMap

Organization Active NPI

Pavillon Outpatient Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Mill Spring, NC
National Provider Identifier
1013696020
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
PAVILLON OUTPATIENT SERVICES
Practice address
115 Pavillon Place
Mill Spring, NC 28756
Phone
(828) 694-2300
Fax
(866) 990-3066
NPI assigned
Jul 17, 2023
Last updated
Jul 17, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
PAVILLON INTERNATIONALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Authorized official

Name
Sean Fitzpatrick
Title
Financial Accountant
Phone
(828) 694-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

115 Pavillon Place
Mill Spring, NC 28756

Mailing address

115 Pavillon Place
Mill Spring, NC 28756

Other identifiers 1

IdentifierTypeStateIssuer
1265512834OtherNCMEDICAL DIRECTOR

National Provider Directory

National Provider Directory
Tax ID family
Pavillon by the Sea8 organizations share this tax ID, including this one
Part of
Pavillon by the Sea

Other organizations with this tax ID 7

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

Locations

115 Pavillon Pl
Mill Spring, NC 28756
Phone (828) 694-2300

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689552000000",
    "number": "1013696020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 PAVILLON PLACE",
            "city": "MILL SPRING",
            "state": "NC",
            "postal_code": "28756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PAVILLON PLACE",
            "city": "MILL SPRING",
            "state": "NC",
            "postal_code": "28756",
            "telephone_number": "828-694-2300",
            "fax_number": "866-990-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVILLON OUTPATIENT SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PAVILLON INTERNATIONAL",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "FITZPATRICK",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "FINANCIAL ACCOUNTANT",
        "authorized_official_telephone_number": "828-694-2300"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL DIRECTOR",
            "identifier": "1265512834",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Spring, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.