NPIMap

Organization Active NPI

County of Wilson

Doing business as Wilson Co. Dept. of Public Health

  • Community Health Clinic/Center
  • Wilson, NC
National Provider Identifier
1467507640
Registry record updated Jul 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
COUNTY OF WILSON
Doing business as
Wilson Co. Dept. of Public Health
Practice address
1801 Glendale Dr SW
Wilson, NC 27893-4401
Phone
(252) 291-5470
Fax
(252) 293-8300
NPI assigned
Jan 25, 2007
Last updated
Jul 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2015

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

Authorized official

Name
Mrs. Teresa Ellen
Title
Health Director
Phone
(252) 237-3141

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU
Community Health Clinic/Center 261QC1500X NU Primary
Non-Surgical Family Planning Clinic/Center 261QF0050X NU
Medical Specialty Clinic/Center 261QM2500X NC
Medical Specialty Clinic/Center 261QM2500X NU
State or Local Public Health Clinic/Center 261QP0905X NC
Primary Care Clinic/Center 261QP2300X NU
Clinical Medical Laboratory 291U00000X NC
Clinical Medical Laboratory 291U00000X NU
Clinic Pharmacy 3336C0002X NC
Clinic Pharmacy 3336C0002X NU

Addresses

Primary practice location

1801 Glendale Dr SW
Wilson, NC 27893-4401

Mailing address

1801 Glendale Dr SW
Wilson, NC 27893-4401
Phone (252) 291-5470

Other identifiers 1

IdentifierTypeStateIssuer
3404398MedicaidNC

Other names 1

  • WILSON CO. DEPT. OF PUBLIC HEALTH Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110304000658 NC Part B Supplier - Public Health/Welfare Agency 2961684410 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Wilson, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Wilson County Dept of Social Services7 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.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

6501 Rock Ridge School Rd
Wilson, NC 27893
Phone (252) 237-0789

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437177600000",
    "number": "1467507640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 GLENDALE DR SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934401",
            "telephone_number": "252-291-5470",
            "fax_number": "252-293-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 GLENDALE DR SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934401",
            "telephone_number": "252-291-5470",
            "fax_number": "252-293-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF WILSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2015-07-18",
        "status": "A",
        "authorized_official_last_name": "ELLEN",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "252-237-3141",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3404398",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WILSON CO. DEPT. OF PUBLIC HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2015; 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.