NPIMap

Organization Active NPI

Nova Inc

  • Psychiatric Residential Treatment Facility
  • Kinston, NC
National Provider Identifier
1124251517
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
MHL-054-126 Issued in NC
Legal business name
NOVA INC
Practice address
2002 D-E Shackleford Road
Kinston, NC 28502-7476
Phone
(252) 233-0491
Fax
(252) 233-0495
NPI assigned
Sep 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Authorized official

Name
Tracey Pridgen
Title
Cfo
Phone
(919) 734-8803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X MHL-054-126 NC Primary

Addresses

Primary practice location

2002 D-E Shackleford Road
Kinston, NC 28502-7476

Mailing address

PO Box 11147
Goldsboro, NC 27532-1147
Phone (252) 233-0491

Other identifiers 2

IdentifierTypeStateIssuer
3404551MedicaidNC
0032HOtherNCBCBSNC

Other names 1

  • Oakwood Facility Other name

National Provider Directory

National Provider Directory
Tax ID family
Nova Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1251763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1124251517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11147",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275321147",
            "telephone_number": "252-233-0491",
            "fax_number": "252-233-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 D-E SHACKLEFORD ROAD",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285027476",
            "telephone_number": "252-233-0491",
            "fax_number": "252-233-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-01",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "919-734-8803"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NC",
            "license": "MHL-054-126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3404551",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "0032H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakwood Facility",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Oakwood Facility",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kinston, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.