NPIMap

Organization Active NPI

Walter B Jones Center Lakeside Psychiatric Hospital

  • Psychiatric Hospital
  • Greenville, NC
National Provider Identifier
1114466893
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
WALTER B JONES CENTER LAKESIDE PSYCHIATRIC HOSPITAL
Practice address
2577 W 5TH St
Greenville, NC 27834-7813
Phone
(252) 830-3426
Fax
(252) 830-0229
NPI assigned
Feb 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Authorized official

Name
Natasha Ashmont
Title
Deputy Secretary Fbbhdd Services
Phone
(252) 830-3426

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X NC Primary
Substance Abuse Rehabilitation Facility 324500000X NC

Addresses

Primary practice location

2577 W 5TH St
Greenville, NC 27834-7813

Mailing address

2577 W 5TH St
Greenville, NC 27834-7813
Phone (252) 830-3426

Other names 1

  • Walter B Jones Alcohol and Drug Abuse Treatment Center Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170508000821 NC Part A Provider - Hospital 1355408931 Practice locations: Greenville, NC

Hospital certification: CCN 344033

Legal name
WALTER B JONES CENTER LAKESIDE PSYCHIATRIC HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Apr 3, 2019
Last certification
Apr 3, 2019
Beds
16
Ownership / control type
State
Organization structure
OtherNon-profit
Incorporated
in NC
Enrollment address
2577 West Fifth Steet
Greenville, NC 27834
Hospital Psychiatric Unit
Hospital subgroups
Other

Care Compare: Hospital

Medicare Care Compare
Listed as
Walter B Jones Center Lakeside Psychiatric HospitaCCN 344033
Type
Psychiatric
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Walter B Jones Center Lakeside Psychiatric Hospital Organization Non-profit Other Feb 1, 2017
Karen Burkes Individual Corporate DirectorDirector of DHHS' Division of St Nov 1, 2022
Laketha M Miller Individual Corporate Officer Mar 1, 2017
W-2 Managing EmployeeController Mar 1, 2017

Practitioners & affiliated clinicians

Practitioners 5

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": "1487116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789084800000",
    "number": "1114466893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2577 W 5TH ST",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347813",
            "telephone_number": "252-830-3426",
            "fax_number": "252-830-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 W 5TH ST",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347813",
            "telephone_number": "252-830-3426",
            "fax_number": "252-830-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER B JONES CENTER LAKESIDE PSYCHIATRIC HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-15",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A",
        "authorized_official_last_name": "ASHMONT",
        "authorized_official_first_name": "NATASHA",
        "authorized_official_title_or_position": "DEPUTY SECRETARY FBBHDD SERVICES",
        "authorized_official_telephone_number": "252-830-3426"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walter B Jones Alcohol and Drug Abuse Treatment Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Walter B Jones Alcohol and Drug Abuse Treatment Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.