NPIMap

Organization Active NPI

Haven

  • Psychiatry Physician
  • Wilmington, NC
National Provider Identifier
1184055436
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
200301378 Issued in NC
Legal business name
HAVEN
Practice address
20 S 16TH St
Wilmington, NC 28401-4924
Phone
(910) 399-3927
Fax
(910) 399-3928
NPI assigned
Dec 11, 2013
Last updated
Dec 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Authorized official

Name
Dr. Dwight Howard Lysne, MD, MDIVNPI 1083679062
Title
Medical Director & Pastor
Phone
(910) 399-3927

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 200301378 NC Primary

Addresses

Primary practice location

20 S 16TH St
Wilmington, NC 28401-4924

Mailing address

20 S 16TH St
Wilmington, NC 28401-4924
Phone (910) 465-1935

National Provider Directory

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386720000000",
    "number": "1184055436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 S 16TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284014924",
            "telephone_number": "910-465-1935",
            "fax_number": "910-399-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S 16TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284014924",
            "telephone_number": "910-399-3927",
            "fax_number": "910-399-3928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-11",
        "last_updated": "2013-12-11",
        "status": "A",
        "authorized_official_last_name": "LYSNE",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR & PASTOR",
        "authorized_official_telephone_number": "910-399-3927",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MDIV"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "200301378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; 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.