Success Dynamics Community Development Corporation

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

SUCCESS DYNAMICS COMMUNITY DEVELOPMENT CORPORATION

Doing business as

Oasis Community Care Services

Practice address

7227 Statonsburg Road
Farmville, NC 27828-0214

Phone

(252) 753-7815

Fax

(252) 753-8787

NPI assigned

Jan 28, 2008

Last updated

Jul 22, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Calvin O. Ellison, N.D., PHD

Title

Executive Director

Phone

(252) 753-7815

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Oasis Community Care Services Doing business as

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1215114715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 214",
            "city": "FARMVILLE",
            "state": "NC",
            "postal_code": "278280214",
            "telephone_number": "252-753-7815",
            "fax_number": "252-753-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7227 STATONSBURG ROAD",
            "city": "FARMVILLE",
            "state": "NC",
            "postal_code": "278280214",
            "telephone_number": "252-753-7815",
            "fax_number": "252-753-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUCCESS DYNAMICS COMMUNITY DEVELOPMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "CALVIN",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "252-753-7815",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "N.D., PHD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8700515",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oasis Community Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Case Management Agency in Farmville, NC
• Providers in Farmville, NC by specialty
• Case Management Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.