NPIMap

Organization Active NPI

University of North Carolina at Pembroke Student Health Services

  • Nurse Practitioner
  • Pembroke, NC
National Provider Identifier
1194282285
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
UNIVERSITY OF NORTH CAROLINA AT PEMBROKE STUDENT HEALTH SERVICES
Practice address
113 Hawk Drive
Pembroke, NC 28372
Phone
(910) 521-6219
Fax
(910) 521-6549
NPI assigned
Feb 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Authorized official

Name
Dr. Jeffery Howard, E.D.D
Title
Vice Chancellor for Student Affairs
Phone
(910) 521-6175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

113 Hawk Drive
Pembroke, NC 28372

Mailing address

PO Box 1510, Unc Pembroke Student Health Services
Pembroke, NC 28372-1510
Phone (910) 521-6219

Other names 1

  • UNCP Student Blue Group Other name

National Provider Directory

National Provider Directory
Tax ID family
Uncp Sports Medicine3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1 University Rd
Pembroke, NC 28372
Phone (910) 521-6000

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": "1551052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764547200000",
    "number": "1194282285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510, UNC PEMBROKE STUDENT HEALTH SERVICES",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283721510",
            "telephone_number": "910-521-6219",
            "fax_number": "910-521-6549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 HAWK DRIVE",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "28372",
            "telephone_number": "910-521-6219",
            "fax_number": "910-521-6549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF NORTH CAROLINA AT PEMBROKE STUDENT HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-25",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_title_or_position": "VICE CHANCELLOR FOR STUDENT AFFAIRS",
        "authorized_official_telephone_number": "910-521-6175",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "E.D.D"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UNCP Student Blue Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pembroke, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.