NPIMap

Organization Active NPI

Wellsprings Center of Goldsboro,P.a.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Goldsboro, NC
National Provider Identifier
1023096088
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
WELLSPRINGS CENTER OF GOLDSBORO,P.A.
Practice address
2719 Graves Dr
Suite 7
Goldsboro, NC 27534-4536
Phone
(919) 583-8448
Fax
(919) 583-8449
NPI assigned
Jan 9, 2006
Last updated
Jun 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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

Authorized official

Name
Mrs. Tamara Tyndall Jarman, LCSW
Title
Owner
Phone
(919) 583-8448

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NC Primary

Addresses

Primary practice location

2719 Graves Dr
Suite 7
Goldsboro, NC 27534-4536

Mailing address

2719 Graves Dr
Suite 7
Goldsboro, NC 27534-4536
Phone (919) 583-8448

Other identifiers 1

IdentifierTypeStateIssuer
6005208MedicaidNC

National Provider Directory

National Provider Directory

Locations

696 N Spence Ave
Ste B
Goldsboro, NC 27534
Phone (919) 583-8448

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1023096088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2719 GRAVES DR",
            "address_2": "SUITE 7",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275344536",
            "telephone_number": "919-583-8448",
            "fax_number": "919-583-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 GRAVES DR",
            "address_2": "SUITE 7",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275344536",
            "telephone_number": "919-583-8448",
            "fax_number": "919-583-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRINGS CENTER OF GOLDSBORO,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "JARMAN",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "TYNDALL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-583-8448",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005208",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.