NPIMap

Organization Active NPI

North Carolina Neuropsychiatry, P.a.

  • Child & Adolescent Psychiatry Physician
  • Chapel Hill, NC
National Provider Identifier
1265403042
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
NORTH CAROLINA NEUROPSYCHIATRY, P.A.
Practice address
1829 E Franklin St Ste 400
Chapel Hill, NC 27514-5865
Phone
(919) 933-2000
Fax
(984) 235-1617
NPI assigned
Jan 30, 2006
Last updated
Feb 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Authorized official

Name
Tiffany Clark
Title
Clinic Administrator
Phone
(919) 933-2000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X NU
Psychologist 103T00000X NU
Child & Adolescent Psychiatry Physician 2084P0804X NU Primary

Addresses

Primary practice location

1829 E Franklin St Ste 400
Chapel Hill, NC 27514-5865

Mailing address

1829 E Franklin St Ste 400
Chapel Hill, NC 27514-5865
Phone (919) 933-2000

Other identifiers 2

IdentifierTypeStateIssuer
6006752MedicaidNC
890143GMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041221000879 NC Part B Supplier - Clinic/Group Practice 4789643982 Receives reassigned benefits from 24 practitioners
Practice locations: Raleigh, NC; Charlotte, NC; Chapel Hill, NC; Apex, NC

National Provider Directory

National Provider Directory

Locations

1829 E Franklin St
Chapel Hill, NC 27514
Phone (919) 260-1243

1829 E Franklin St
Ste 400
Chapel Hill, NC 27514
Phone (919) 785-5055

400 Franklin Sq
Chapel Hill, NC 27514

Practitioners & affiliated clinicians

Practitioners 47

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 47

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1265403042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 E FRANKLIN ST STE 400",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275145865",
            "telephone_number": "919-933-2000",
            "fax_number": "984-235-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 E FRANKLIN ST STE 400",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275145865",
            "telephone_number": "919-933-2000",
            "fax_number": "984-235-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA NEUROPSYCHIATRY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "919-933-2000"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006752",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890143G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.