NPIMap

Organization Active NPI

Primary Care Solutions Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Charlotte, NC
National Provider Identifier
1265574594
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
PRIMARY CARE SOLUTIONS INC.
Practice address
4616 E WT Harris Blvd
Charlotte, NC 28215
Phone
(704) 566-0446
Fax
(704) 569-0822
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Authorized official

Name
Mr. William A. Bullock, QP
Title
President
Phone
(704) 537-1022

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL-060-537 NC
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

4616 E WT Harris Blvd
Charlotte, NC 28215

Mailing address

5601 Executive Center Dr Ste 200
Charlotte, NC 28212-8841
Phone (704) 537-1022

Other identifiers 1

IdentifierTypeStateIssuer
6603406MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Primary Care Solutions Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

4616 E Wt Harris Blvd
Charlotte, NC 28215
Phone (704) 566-0446

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1265574594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 EXECUTIVE CENTER DR STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128841",
            "telephone_number": "704-537-1022",
            "fax_number": "704-569-0822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4616 E WT HARRIS BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28215",
            "telephone_number": "704-566-0446",
            "fax_number": "704-569-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE SOLUTIONS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-537-1022",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "QP"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-060-537",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603406",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; 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.