Covenant Primary & Behavioral Care

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

COVENANT PRIMARY & BEHAVIORAL CARE

Practice address

812 Candy Park Rd Ste 6101-a
Pembroke, NC 28372-9120

Phone

(910) 778-5455

Fax

(866) 423-7783

NPI assigned

May 27, 2021

Last updated

Jul 25, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. William Joshua Johnson, MSN FNP, PMHNPNPI 1578924130

Title

Ceo & Provider

Phone

(910) 778-5455

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

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.

• William Joshua Johnson, MSN, FNP-C, PMHNP-BC

  • Family Nurse Practitioner
  • Pembroke, NC
  • NPI 1578924130
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1346816667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1629",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283721629",
            "telephone_number": "910-778-5455",
            "fax_number": "910-208-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 CANDY PARK RD STE 6101-A",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283729120",
            "telephone_number": "910-778-5455",
            "fax_number": "866-423-7783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT PRIMARY & BEHAVIORAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-27",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "JOSHUA",
        "authorized_official_title_or_position": "CEO & PROVIDER",
        "authorized_official_telephone_number": "910-778-5455",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSN FNP, PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeff Collins, D.D.S.
• Tyler Jeffrey Collins, DDS
• Comfort Care Services, LLC
• Community Health Innovation, Inc.
• Country Layne, LLC
• Deanna Crawford
• Crossroads Associates
• Crossroads Associates
• Crossroads Associates
• Crossroads Associates

• Multi-Specialty Clinic/Center in Pembroke, NC
• Providers in Pembroke, NC by specialty
• Multi-Specialty Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.