NPIMap

Organization Active NPI

New Outlook Second Chance, Inc.

  • Case Management Agency
  • Durham, NC
National Provider Identifier
1255497244
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
632008 Issued in NC
Legal business name
NEW OUTLOOK SECOND CHANCE, INC.
Practice address
2604 Carver St
Suite C
Durham, NC 27705-2796
Phone
(919) 682-4771
Fax
(919) 683-2641
NPI assigned
Dec 28, 2006
Last updated
Oct 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Authorized official

Name
Ms. Bethena Mechele Jackson, MA,LCAS-ANPI 1881930006
Title
Executive Director
Phone
(919) 682-4771

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
Case Management Agency 251B00000X 632008 NC Primary

Addresses

Primary practice location

2604 Carver St
Suite C
Durham, NC 27705-2796

Mailing address

2604 Carver St
Suite C
Durham, NC 27705-2796
Phone (919) 682-4771

Other identifiers 1

IdentifierTypeStateIssuer
8700391MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
New Outlook Second Chance Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

2604 Carver St
Ste C
Durham, NC 27705
Phone (919) 682-4771

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": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349654400000",
    "number": "1255497244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 CARVER ST",
            "address_2": "SUITE C",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277052796",
            "telephone_number": "919-682-4771",
            "fax_number": "919-683-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 CARVER ST",
            "address_2": "SUITE C",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277052796",
            "telephone_number": "919-682-4771",
            "fax_number": "919-683-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW OUTLOOK SECOND CHANCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2012-10-08",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BETHENA",
        "authorized_official_middle_name": "MECHELE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-682-4771",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA,LCAS-A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": "632008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8700391",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.