NPIMap

Organization Active NPI

Carolina Healthcare Associates Inc

Doing business as CHA Division of Psychiatry

  • Psychiatry Physician
  • Wilmington, NC
National Provider Identifier
1417196304
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
CAROLINA HEALTHCARE ASSOCIATES INC
Doing business as
CHA Division of Psychiatry
Practice address
2131 S 17TH St
Wilmington, NC 28401-7407
Phone
(910) 815-5830
NPI assigned
Feb 17, 2009
Last updated
May 6, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINA HEALTHCARE ASSOCIATES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Authorized official

Name
Daniel Goodwin
Title
Vice-President
Phone
(910) 667-7597

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

2131 S 17TH St
Wilmington, NC 28401-7407

Mailing address

PO Box 19305
Charlotte, NC 28219-9305
Phone (704) 631-0002

Other names 1

  • CHA Division of Psychiatry Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ambulatory@direct.carolinashealthcare.org Atrium Health

National Provider Directory

National Provider Directory
Part of
Carolina Healthcare Ass

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": "1620259200000",
    "number": "1417196304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305",
            "telephone_number": "704-631-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017407",
            "telephone_number": "910-815-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA HEALTHCARE ASSOCIATES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINA HEALTHCARE ASSOCIATES INC",
        "enumeration_date": "2009-02-17",
        "last_updated": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "910-667-7597"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "2131 S 17th St",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284017407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "CHA Division of Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHA Division of Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.