NPIMap

Organization Active NPI

County of Duplin

Doing business as Duplin County Health Services

  • State or Local Public Health Clinic/Center
  • Kenansville, NC
National Provider Identifier
1235198177
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
COUNTY OF DUPLIN
Doing business as
Duplin County Health Services
Practice address
340 Seminary St
Kenansville, NC 28349-8978
Phone
(910) 296-2130
Fax
(910) 296-0252
NPI assigned
Mar 20, 2006
Last updated
Jul 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Authorized official

Name
Ila Davis
Title
Health Director
Phone
(910) 296-2130

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community Health Clinic/Center 261QC1500X
Dental Clinic/Center 261QD0000X
Non-Surgical Family Planning Clinic/Center 261QF0050X
Medical Specialty Clinic/Center 261QM2500X
State or Local Public Health Clinic/Center 261QP0905X Primary
Primary Care Clinic/Center 261QP2300X
Clinical Medical Laboratory 291U00000X 34D0676814 NC
Clinic Pharmacy 3336C0002X 04381 NC

Addresses

Primary practice location

340 Seminary St
Kenansville, NC 28349-8978

Mailing address

340 Seminary St
Kenansville, NC 28349-8978
Phone (910) 296-2130

Other identifiers 2

IdentifierTypeStateIssuer
3404331MedicaidNC
0721MOtherNCBCBS GROUP #

Other names 1

  • Duplin County Health Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040512001545 NC Part B Supplier - Clinic/Group Practice 1456341536 Receives reassigned benefits from 4 practitioners
Practice locations: Kenansville, NC

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
County of Duplin4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

340 Seminary St
Kenansville, NC 28349
Phone (910) 296-2130

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1235198177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 SEMINARY ST",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "283498978",
            "telephone_number": "910-296-2130",
            "fax_number": "910-296-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 SEMINARY ST",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "283498978",
            "telephone_number": "910-296-2130",
            "fax_number": "910-296-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF DUPLIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ILA",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "910-296-2130"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NC",
            "license": "34D0676814",
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NC",
            "license": "04381",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3404331",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "0721M",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duplin County Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kenansville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.