NPIMap

Organization Active NPI

Nova Behavioral Healthcare Corp.

  • Community/Behavioral Health Agency
  • Kinston, NC
National Provider Identifier
1346471265
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NOVA BEHAVIORAL HEALTHCARE CORP.
Practice address
2002 Shackleford Rd
Kinston, NC 28504-8917
Phone
(252) 233-0491
Fax
(252) 233-0495
NPI assigned
Jul 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Authorized official

Name
Tracey Pridgen
Title
Cfo
Phone
(919) 734-8803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2002 Shackleford Rd
Kinston, NC 28504-8917

Mailing address

PO Box 11147
Goldsboro, NC 27532-1147
Phone (919) 734-8803

Other identifiers 1

IdentifierTypeStateIssuer
8300789HMedicaidNC

Other names 1

  • NOVA-INC. Other name

National Provider Directory

National Provider Directory
Tax ID family
Nova 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.

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1346471265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11147",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275321147",
            "telephone_number": "919-734-8803",
            "fax_number": "919-735-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 SHACKLEFORD RD",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285048917",
            "telephone_number": "252-233-0491",
            "fax_number": "252-233-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA BEHAVIORAL HEALTHCARE CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-28",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "919-734-8803"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300789H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NOVA-INC.",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "NOVA-INC.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kinston, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.