NPIMap

Organization Active NPI

Wilson Professional Services Treatment Center

  • Community/Behavioral Health Agency
  • Wilson, NC
National Provider Identifier
1346667938
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL-098-190 Issued in NC
Legal business name
WILSON PROFESSIONAL SERVICES TREATMENT CENTER
Practice address
3709 Nash St NW
Wilson, NC 27896-1127
Phone
(252) 206-5799
Fax
(252) 206-5778
NPI assigned
Mar 21, 2014
Last updated
Dec 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Authorized official

Name
Jay Higham
Title
Ceo
Phone
(214) 365-6112

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Community/Behavioral Health Agency 251S00000X
Community/Behavioral Health Agency 251S00000X MHL-098-190 NC Primary

Addresses

Primary practice location

3709 Nash St NW
Wilson, NC 27896-1127

Mailing address

5001 Spring Valley Road
Suite 600 East
Dallas, TX 75244-3946
Phone (214) 365-6100

Other practice location 1

2223 Nash St NW
Wilson, NC 27896-1735
Phone (252) 206-5799

Other names 1

  • Wilson Professional Services Treatment Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Opioid treatment program
Medicare-enrolled since Jan 7, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200219002945 NC Part B Supplier - Opioid Treatment Program (Otp) 4284061854 Practice locations: Wilson, NC

National Provider Directory

National Provider Directory
Tax ID family
Wilson Professional Services Treatment Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • DRD Management, Inc

    dba BHG Springfield Treatment Center

    • Substance Use Disorder Rehabilitation Clinic/Center
    • Springfield, MO
    • NPI 1134380405

    Member Of

    NPD member

Locations

2223 Nash St NW
Wilson, NC 27896
Phone (252) 206-5799

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1395360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1346667938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 SPRING VALLEY ROAD",
            "address_2": "SUITE 600 EAST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443946",
            "telephone_number": "214-365-6100",
            "fax_number": "214-365-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3709 NASH ST NW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278961127",
            "telephone_number": "252-206-5799",
            "fax_number": "252-206-5778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2223 Nash St NW",
            "address_purpose": "LOCATION",
            "city": "Wilson",
            "state": "NC",
            "postal_code": "278961735",
            "country_code": "US",
            "telephone_number": "252-206-5799",
            "fax_number": "252-206-5778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WILSON PROFESSIONAL SERVICES TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-21",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A",
        "authorized_official_last_name": "HIGHAM",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-365-6112"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-098-190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilson Professional Services Treatment Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wilson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; 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.