NPIMap

Organization Active NPI

Craven County

  • Community Based Hospice Care Agency
  • New Bern, NC
National Provider Identifier
1154399434
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HOS4682 Issued in NC
Legal business name
CRAVEN COUNTY
Practice address
2818 Neuse Blvd
New Bern, NC 28562-2839
Phone
(252) 636-4930
Fax
(252) 636-5301
NPI assigned
Mar 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Authorized official

Name
D. Scott Harrelson
Title
Health Director
Phone
(252) 636-4930

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0002X NC
Community Based Hospice Care Agency 251G00000X HOS4682 NC Primary

Addresses

Primary practice location

2818 Neuse Blvd
New Bern, NC 28562-2839

Mailing address

PO Box 12610
New Bern, NC 28561-2610
Phone (252) 636-4930

Other identifiers 2

IdentifierTypeStateIssuer
0020ROtherNCHOSPICE PROV.# --NC BC/BS
3401545MedicaidNC

Other names 1

  • Craven County Hospice Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110520000293 NC Part B Supplier - Clinic/Group Practice 3678626579 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Havelock, NC; New Bern, NC
O20120312000731 NC Part A Provider - Hospice 3678626579 Practice locations: New Bern, NC

Hospice certification: CCN 341545

Legal name
CRAVEN COUNTY
Doing business as
CRAVEN COUNTY HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 29, 1989
Last certification
Oct 20, 2021
Ownership / control type
Government - City-County
Organization structure
GovernmentNon-profit
Enrollment address
2818 Neuse Blvd
New Bern, NC 28562-2850

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospice

Medicare Care Compare
Listed as
Craven County HospiceCCN 341545
Ownership
Government
Certified
Nov 29, 1989
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Craven County Department of Social Services8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

717 N D St
Bridgeton, NC 28519
Phone (252) 637-5211

417 S Main St
Cove City, NC 28523
Phone (252) 637-7174

9334 NC Highway 55 W
Dover, NC 28526
Phone (252) 522-1211

508 US Highway 70 W
Havelock, NC 28532
Phone (252) 444-1533

2103 Old Cherry Point Rd
New Bern, NC 28560
Phone (252) 638-1059

406 Craven St
New Bern, NC 28560
Phone (252) 636-6608

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
David Harrelson Individual W-2 Managing EmployeeHealth Director Nov 15, 2011
Craven County Organization, New Bern, NC 5% Or Greater Direct Ownership Interest Nov 15, 2011 100%
Operational/Managerial Control Nov 15, 2011 100%
Craig Warren Individual Corporate DirectorFinance Director Sep 1, 2016
W-2 Managing EmployeeFinance Director Sep 1, 2016

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Craven County
    • State or Local Public Health Clinic/Center
    • New Bern, NC
    • NPI 1295801827

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Craven County
    • Land Ambulance
    • New Bern, NC
    • NPI 1629015516

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430092800000",
    "number": "1154399434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12610",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285612610",
            "telephone_number": "252-636-4930",
            "fax_number": "252-636-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2818 NEUSE BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622839",
            "telephone_number": "252-636-4930",
            "fax_number": "252-636-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAVEN COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2015-04-27",
        "status": "A",
        "authorized_official_last_name": "HARRELSON",
        "authorized_official_first_name": "D.",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "252-636-4930"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NC",
            "license": "HOS4682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPICE PROV.# --NC BC/BS",
            "identifier": "0020R",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3401545",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Craven County Hospice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Bern, NC

Sources for this page

Verify at the official NPI Registry.