Active NPI
Supreme Investments,LLC
- Community/Behavioral Health Agency
- New Bern, NC
National Provider Identifier
1093089583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- SUPREME INVESTMENTS,LLC
- Practice address
- 2407 Grace Ave
Ste 4-5
New Bern, NC 28562-4416 - Phone
- (252) 772-2304
- Fax
- (252) 523-1101
- NPI assigned
- Feb 29, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nikisha Williams
- Title
- Manager
- Phone
- (252) 523-1100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
2407 Grace Ave
Ste 4-5
New Bern, NC 28562-4416
Mailing address
2407 Grace Ave
Suites 4-5
New Bern, NC 28562-4416
Phone (252) 772-2304
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3418755 | Medicaid | NC |
Other names 1
- SUPREME CHOICE HEALTHCARE
National Provider Directory
National Provider Directory- Tax ID family
- Supreme Choice Healthcare
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Kinston, NC
- NPI 1316276975
-
- Case Management Agency
- Kinston, NC
- NPI 1952604365
-
- Home Health Agency
- Fayetteville, NC
- NPI 1487982260
Locations
2407 Grace Ave
#45
New Bern, NC 28562
2407 Grace Ave
Ste 45
New Bern, NC 28562
Phone (252) 772-2304
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330473600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1330473600000",
"number": "1093089583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2407 GRACE AVE",
"address_2": "SUITES 4-5",
"city": "NEW BERN",
"state": "NC",
"postal_code": "285624416",
"telephone_number": "252-772-2304",
"fax_number": "252-523-1101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2407 GRACE AVE",
"address_2": "STE 4-5",
"city": "NEW BERN",
"state": "NC",
"postal_code": "285624416",
"telephone_number": "252-772-2304",
"fax_number": "252-523-1101"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUPREME INVESTMENTS,LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-02-29",
"last_updated": "2012-02-29",
"status": "A",
"authorized_official_last_name": "WILLIAMS",
"authorized_official_first_name": "NIKISHA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "252-523-1100"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3418755",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SUPREME CHOICE HEALTHCARE",
"code": "3",
"type": "Doing Business As"
}
]
}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 Feb 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.