NPIMap

Organization Active NPI

University of North Carolina at Pembroke Student Health Services

  • Adolescent Medicine (Family Medicine) Physician
  • Pembroke, NC
National Provider Identifier
1356845309
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X
License
183091 Issued in NC
Legal business name
UNIVERSITY OF NORTH CAROLINA AT PEMBROKE STUDENT HEALTH SERVICES
Practice address
113 Hawk Drive
Pembroke, NC 28372-1510
Phone
(910) 521-6219
Fax
(910) 521-6549
NPI assigned
Mar 22, 2018
Last updated
Jul 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Authorized official

Name
Dr. Jeffery L. Howard, ED.D
Title
Vice Chancellor for Student Affairs
Phone
(910) 521-6175

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207QA0000X 183091 NC Primary
Adult Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207QA0505X 183091 NC

Addresses

Primary practice location

113 Hawk Drive
Pembroke, NC 28372-1510

Mailing address

PO Box 1510 Unc Pembroke Student Health Services
Pembroke, NC 28372-1510
Phone (910) 521-6219

National Provider Directory

National Provider Directory
Tax ID family
Uncp Sports Medicine3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1521676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1356845309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510 UNC PEMBROKE STUDENT HEALTH SERVICES",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283721510",
            "telephone_number": "910-521-6219",
            "fax_number": "910-521-6549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 HAWK DRIVE",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283721510",
            "telephone_number": "910-521-6219",
            "fax_number": "910-521-6549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF NORTH CAROLINA AT PEMBROKE STUDENT HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-22",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE CHANCELLOR FOR STUDENT AFFAIRS",
        "authorized_official_telephone_number": "910-521-6175",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "NC",
            "license": "183091",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NC",
            "license": "183091",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.