Ability Club Corporation

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ABILITY CLUB CORPORATION

Practice address

11551 Pine Dr
Gulfport, MS 39503-3998

Phone

(251) 404-0016

NPI assigned

Oct 27, 2014

Organization subpart

No

Name

Mr. Wade Mitchell Ogletree, MS

Title

Ceo

Phone

(251) 404-0016

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 27, 2014.

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1275938763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11551 PINE DR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033998",
            "telephone_number": "251-404-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11551 PINE DR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033998",
            "telephone_number": "251-404-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABILITY CLUB CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "OGLETREE",
        "authorized_official_first_name": "WADE",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "251-404-0016",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.