NPIMap

Organization Active NPI

Precision Health Care Services

  • Psychologist
  • Wilmington, NC
National Provider Identifier
1447675285
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
PRECISION HEALTH CARE SERVICES
Practice address
311 Judges Rd
BLDG 4
Wilmington, NC 28405-3651
Phone
(910) 791-6767
NPI assigned
Mar 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Authorized official

Name
Matt Fetter
Title
Corporate Director
Phone
(252) 327-1815

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X NC Primary

Addresses

Primary practice location

311 Judges Rd
BLDG 4
Wilmington, NC 28405-3651

Mailing address

311 Judges Rd
BLDG 4
Wilmington, NC 28405-3651
Phone (910) 791-6767

Other identifiers 2

IdentifierTypeStateIssuer
024MWOtherNCBCBS
3410033MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Precision Health Care Services Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

311 Judges Rd
Bldg 4
Wilmington, NC 28405

NPI Registry JSON

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406592000000",
    "number": "1447675285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 JUDGES RD",
            "address_2": "BLDG 4",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053651",
            "telephone_number": "910-791-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 JUDGES RD",
            "address_2": "BLDG 4",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053651",
            "telephone_number": "910-791-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION HEALTH CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-04",
        "last_updated": "2014-07-29",
        "status": "A",
        "authorized_official_last_name": "FETTER",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "CORPORATE DIRECTOR",
        "authorized_official_telephone_number": "252-327-1815"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "024MW",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3410033",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 29, 2014; 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.