NPIMap

Organization Active NPI

Innovative Programming Associates, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Elizabeth City, NC
National Provider Identifier
1063470656
Registry record updated Dec 7, 2007
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
INNOVATIVE PROGRAMMING ASSOCIATES, INC.
Practice address
1134 N Road St Ste 6
Elizabeth City, NC 27909-3365
Phone
(252) 338-9005
Fax
(252) 338-9007
NPI assigned
May 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Authorized official

Name
Leslie Coley
Title
Billing Supervisor
Phone
(910) 483-0734

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NC Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NC
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NC
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NC
Substance Abuse Rehabilitation Facility 324500000X NC

Addresses

Primary practice location

1134 N Road St Ste 6
Elizabeth City, NC 27909-3365

Mailing address

111 Lamon St
Fayetteville, NC 28301-4957
Phone (910) 483-0734

Other identifiers 9

IdentifierTypeStateIssuer
8300767BMedicaidNC
8300767IMedicaidNC
8300767JMedicaidNC
8300767GMedicaidNC
8300767HMedicaidNC
8300767QMedicaidNC
8300767MedicaidNC
8300767AMedicaidNC
6103427MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Innovative Programming Associates Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

1134 N Road St
Ste 6
Elizabeth Cty, NC 27909
Phone (252) 335-5128

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1063470656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 LAMON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283014957",
            "telephone_number": "910-483-0734",
            "fax_number": "910-483-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 N ROAD ST STE 6",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093365",
            "telephone_number": "252-338-9005",
            "fax_number": "252-338-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PROGRAMMING ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "COLEY",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "910-483-0734"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300767B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300767I",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300767J",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300767G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300767H",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300767Q",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300767",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300767A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103427",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.