NPIMap

Organization Active NPI

Premier Behavioral Services Inc

  • Community/Behavioral Health Agency
  • Lumberton, NC
National Provider Identifier
1457657645
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PREMIER BEHAVIORAL SERVICES INC
Practice address
2003 Godwin Ave
Suite B
Lumberton, NC 28358-3197
Phone
(910) 671-1111
Fax
(910) 671-4454
NPI assigned
Feb 4, 2011
Organization subpart
Yes
Parent organization
PREMIER BEHAVIORAL SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Dr. Santhosh Augustine, MDNPI 1689663700
Title
President
Phone
(910) 733-2007

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X C001816 NC
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 9600445 NC
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 19520 NC
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2003 Godwin Ave
Suite B
Lumberton, NC 28358-3197

Mailing address

2003 Godwin Avenue
Suite B
Lumberton, NC 28358-3197
Phone (910) 671-1111

Other names 1

  • Premier Behavioral Services Inc Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120829000314 NC Part B Supplier - Clinic/Group Practice 6406003334 Receives reassigned benefits from 6 practitioners
Practice locations: Lumberton, NC

National Provider Directory

National Provider Directory
Part of
Premier Behavioral Services Inc

Locations

1007 Woodridge Dr
Lumberton, NC 28358

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

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": "1296777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1457657645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 GODWIN AVENUE",
            "address_2": "SUITE B",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583197",
            "telephone_number": "910-671-1111",
            "fax_number": "910-671-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 GODWIN AVE",
            "address_2": "SUITE B",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583197",
            "telephone_number": "910-671-1111",
            "fax_number": "910-671-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER BEHAVIORAL SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER BEHAVIORAL SERVICES INC",
        "enumeration_date": "2011-02-04",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "AUGUSTINE",
        "authorized_official_first_name": "SANTHOSH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-733-2007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C001816",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9600445",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "19520",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Behavioral Services Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.