NPIMap

Organization Active NPI

Psychological Mobile Services, PA

  • Psychologist
  • Wilson, NC
National Provider Identifier
1104179340
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3681 Issued in NC
Legal business name
PSYCHOLOGICAL MOBILE SERVICES, PA
Practice address
2401 Wooten Blvd SW Ste K
Wilson, NC 27893-4464
Phone
(919) 252-8896
NPI assigned
Oct 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

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

Authorized official

Name
Steven N Hannant, PSY.D.NPI 1811013790
Title
Ownder
Phone
(919) 252-8896

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 3681 NC Primary

Addresses

Primary practice location

2401 Wooten Blvd SW Ste K
Wilson, NC 27893-4464

Mailing address

779 True Vine Rd NE
Pikeville, NC 27863-8800
Phone (919) 252-8896

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130715000346 NC Part B Supplier - Clinic/Group Practice 9931349040 Receives reassigned benefits from 4 practitioners
Practice locations: Clayton, NC; Wilson, NC

National Provider Directory

National Provider Directory
Tax ID family
Psychological Mobile Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2401 Wooten Blvd SW
Ste K
Wilson, NC 27893
Phone (252) 230-0293

Practitioners & affiliated clinicians

Practitioners 9

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": "1351123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351814400000",
    "number": "1104179340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "779 TRUE VINE RD NE",
            "city": "PIKEVILLE",
            "state": "NC",
            "postal_code": "278638800",
            "telephone_number": "919-252-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 WOOTEN BLVD SW STE K",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934464",
            "telephone_number": "919-252-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL MOBILE SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-11-02",
        "status": "A",
        "authorized_official_last_name": "HANNANT",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNDER",
        "authorized_official_telephone_number": "919-252-8896",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; 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.