NPIMap

Organization Active NPI

Metropolitan Community Health Services, Inc

Doing business as Agape Health Services Mobile Unit

  • Federally Qualified Health Center (FQHC)
  • Washington, NC
National Provider Identifier
1285211326
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
METROPOLITAN COMMUNITY HEALTH SERVICES, INC
Doing business as
Agape Health Services Mobile Unit
Practice address
120 W Martin Luther King Jr Dr
Washington, NC 27889-4906
Phone
(252) 644-7003
NPI assigned
Mar 25, 2021
Last updated
Oct 26, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
METROPOLITAN COMMUNITY HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Authorized official

Name
Laurence J Doby
Title
Executive Director
Phone
(252) 644-7003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

120 W Martin Luther King Jr Dr
Washington, NC 27889-4906

Mailing address

120 W Martin Luther King Jr Dr
Washington, NC 27889-4906
Phone (252) 644-7003

Other names 1

  • Agape Health Services Mobile Unit Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040630000822 NC Part B Supplier - Clinic/Group Practice 9931010881 Receives reassigned benefits from 46 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Williamston, NC; Washington, NC; Plymouth, NC
O20221024001682 NC Part A Provider - Federally Qualified Health Center (FQHC) 9931010881 Practice locations: Washington, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285211326. Details of each certification follow.

Federally qualified health center certification: CCN 341179

Legal name
METROPOLITAN COMMUNITY HEALTH SERVICES INC
Doing business as
AGAPE HEALTH SERVICES MOBILE UNIT
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 4, 2022
Last certification
Oct 4, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 30, 1999 in NC
Enrollment address
120 W Martin Luther King Jr Dr
Washington, NC 27889-4906

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Metropolitan Community Health Services Inc

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Laurence J Doby Individual W-2 Managing EmployeeExecutive Director Sep 1, 2013
Michael L McDuffie Individual Corporate DirectorChief Executive Officer Jun 23, 2014 100%
Metropolitan Community Health Services Inc Organization, Washington, NC Non-profit Operational/Managerial Control Jan 1, 1999 100%

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Agape Community Health CenterWilliamston, NC, CCN 341021 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 14, 2013
Agape Health Services- PlymouthPlymouth, NC, CCN 341174 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2022
Agape Health Services - Carolina AvenueWashington, NC, CCN B61073 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 16, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1285211326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MARTIN LUTHER KING JR DR",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278894906",
            "telephone_number": "252-644-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W MARTIN LUTHER KING JR DR",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278894906",
            "telephone_number": "252-644-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN COMMUNITY HEALTH SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METROPOLITAN COMMUNITY HEALTH SERVICES, INC.",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "DOBY",
        "authorized_official_first_name": "LAURENCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "252-644-7003"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agape Health Services Mobile Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Washington, NC

Sources for this page

Verify at the official NPI Registry.