NPIMap

Organization Active NPI

Mid-State Health Systems, Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Fayetteville, NC
National Provider Identifier
1477634319
Registry record updated Sep 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
MHL-026-054 Issued in NC
Legal business name
MID-STATE HEALTH SYSTEMS, INC
Practice address
4309 N.C. Hwy 87 S
Fayetteville, NC 28306-9818
Phone
(910) 484-3717
Fax
(910) 484-1315
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2026

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

Authorized official

Name
Mrs. Sera W Gilmore
Title
Administrator
Phone
(910) 484-3717

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Intellectual Disabilities Intermediate Care Facility 315P00000X MHL-026-054 NC Primary

Addresses

Primary practice location

4309 N.C. Hwy 87 S
Fayetteville, NC 28306-9818

Mailing address

3721 Legion Rd
Hope Mills, NC 28348-8411
Phone (910) 484-3717

Other identifiers 1

IdentifierTypeStateIssuer
3406591MedicaidNC

Other names 1

  • No Place Like Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mid-State Health Systems Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789257600000",
    "number": "1477634319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 LEGION RD",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283488411",
            "telephone_number": "910-484-3717",
            "fax_number": "910-484-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 N.C. HWY 87 S",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283069818",
            "telephone_number": "910-484-3717",
            "fax_number": "910-484-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-STATE HEALTH SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2026-09-13",
        "certification_date": "2026-09-13",
        "status": "A",
        "authorized_official_last_name": "GILMORE",
        "authorized_official_first_name": "SERA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-484-3717",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NC",
            "license": "MHL-026-054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406591",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "No Place Like Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2026; 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.