Oversight Community Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

4273 Issued in NC

Legal business name

OVERSIGHT COMMUNITY SERVICES

Practice address

2543 Ravenhill Dr
Suite E
Fayetteville, NC 28303-9618

Phone

(910) 728-4564

Fax

(910) 223-0255

NPI assigned

Jun 3, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Tracy Ann Johnson

Title

Ceo/Administrative Director

Phone

(910) 728-4564

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243987200000",
    "number": "1447486592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2543 RAVENHILL DR",
            "address_2": "SUITE E",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283039618",
            "telephone_number": "910-728-4564",
            "fax_number": "910-223-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2543 RAVENHILL DR",
            "address_2": "SUITE E",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283039618",
            "telephone_number": "910-728-4564",
            "fax_number": "910-223-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERSIGHT COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-03",
        "last_updated": "2009-06-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CEO/ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "910-728-4564",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "4273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Owen Drive Surgical Clini
• Owen Drive Surgical Clinic of Fayetteville PLLC
• Owen Drive Surgical Clinic, PA
• Owen Park Pediatrics, PA
• Melissa Owen, LAT, ATC

• Community/Behavioral Health Agency in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.