NPIMap

Organization Active NPI

Polk County Community Health & Wellness Center, Inc

  • Community/Behavioral Health Agency
  • Columbus, NC
National Provider Identifier
1386883296
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
POLK COUNTY COMMUNITY HEALTH & WELLNESS CENTER, INC
Practice address
801 W Mills St Ste a&B
Columbus, NC 28722-8494
Phone
(828) 894-2222
NPI assigned
Feb 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Authorized official

Name
Mary Jo Stark
Title
Office Manager
Phone
(828) 894-2222

Specialties & licenses 1

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

Addresses

Primary practice location

801 W Mills St Ste a&B
Columbus, NC 28722-8494

Mailing address

PO Box 130
Columbus, NC 28722-0130
Phone (828) 894-2222

Other identifiers 6

IdentifierTypeStateIssuer
6102994MedicaidNC
7912153MedicaidNC
6005017MedicaidNC
1740484575OtherNCNPI
6106296MedicaidNC
6000122MedicaidNC

National Provider Directory

National Provider Directory

Locations

155E MLS St 201
Columbus, NC 28722
Phone (828) 894-2222

801 W Mills St
Ste A
Columbus, NC 28722
Phone (828) 894-0277

801 W Mills St
Ste Ab
Columbus, NC 28722
Phone (828) 894-2222

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1386883296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "COLUMBUS",
            "state": "NC",
            "postal_code": "287220130",
            "telephone_number": "828-894-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W MILLS ST STE A&B",
            "city": "COLUMBUS",
            "state": "NC",
            "postal_code": "287228494",
            "telephone_number": "828-894-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK COUNTY COMMUNITY HEALTH & WELLNESS CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-17",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "MARY JO",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "828-894-2222"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102994",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7912153",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005017",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1740484575",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106296",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000122",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; 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.