Active NPI
Brynn Marr Hospital, Inc
- Psychiatric Residential Treatment Facility
- Jacksonville, NC
National Provider Identifier
1144207804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Residential Treatment Facility
- Legal business name
- BRYNN MARR HOSPITAL, INC
- Doing business as
- Brynn Marr Hospital
- Practice address
- 192 Village Dr
Jacksonville, NC 28546 - Phone
- (910) 577-1400
- Fax
- (910) 577-2766
- NPI assigned
- Dec 23, 2005
- 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
- Steve Filton
- Title
- Vice President
- Phone
- (610) 768-3482
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Residential Treatment Facility | 323P00000X | Primary |
Addresses
Primary practice location
192 Village Dr
Jacksonville, NC 28546
Mailing address
192 Village Dr
Jacksonville, NC 28546
Phone (910) 577-1400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3404500 | Medicaid | NC | |
| 001AM | Other | NC | BCBS |
Other names 1
- Brynn Marr Hospital
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Psychiatric residential treatment facility certification: CCN 34L002
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- BRYNN MARR HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Psychiatric residential treatment facility
- Participating since
- Jul 23, 2001
- Last certification
- Apr 14, 2005
- Beds
- 34
- Ownership / control type
- Non-profit – corporation
- Facility address
- 192 Village Drive
Jacksonville, NC 28546
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Child & Adolescent Psychiatry Physician
- Wilmington, NC
- NPI 1275693517
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135296000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1706659200000",
"number": "1144207804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "192 VILLAGE DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "28546",
"telephone_number": "910-577-1400",
"fax_number": "910-577-2766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "192 VILLAGE DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "28546",
"telephone_number": "910-577-1400",
"fax_number": "910-577-2766"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRYNN MARR HOSPITAL, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-23",
"last_updated": "2024-01-31",
"certification_date": "2024-01-31",
"status": "A",
"authorized_official_last_name": "FILTON",
"authorized_official_first_name": "STEVE",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "610-768-3482"
},
"taxonomies": [
{
"code": "323P00000X",
"taxonomy_group": "",
"desc": "Psychiatric Residential Treatment Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3404500",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "001AM",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Brynn Marr Hospital",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.