NPIMap

Organization Active NPI

Nova Ic, Inc.

  • Community/Behavioral Health Agency
  • Greenville, NC
National Provider Identifier
1477882249
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NOVA IC, INC.
Practice address
1031 WH Smith Blvd
Greenville, NC 27834-5052
Phone
(252) 493-6525
Fax
(855) 492-1625
NPI assigned
Dec 8, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Authorized official

Name
Tracey Pridgen
Title
Cfo
Phone
(919) 734-8803

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
PsychoanalystGroup: 193200000X MULTI-SPECIALTY GROUP 102L00000X 2518 NC
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 0715 NC
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X C005336 NC
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X C004079 NC
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 34782 NC
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1031 WH Smith Blvd
Greenville, NC 27834-5052

Mailing address

PO Box 11077
Goldsboro, NC 27532-1077
Phone (919) 734-8803

Other practice location 1

2307 Norwood Ave Ste A
Goldsboro, NC 27534-1601
Phone (919) 735-4736 ext. 302

Other practice location 2

118 Oakmont Dr
Greenville, NC 27858-5936
Phone (252) 493-6525

Other identifiers 1

IdentifierTypeStateIssuer
6006439MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Nova Ic Inc18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

118 Oakmont Dr
Greenville, NC 27858
Phone (252) 364-8790

1031 Wh Smith Blvd
Greenville, NC 27834
Phone (252) 493-6525

Practitioners & affiliated clinicians

Practitioners 33

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.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790121600000",
    "number": "1477882249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11077",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275321077",
            "telephone_number": "919-734-8803",
            "fax_number": "919-735-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 WH SMITH BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345052",
            "telephone_number": "252-493-6525",
            "fax_number": "855-492-1625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2307 Norwood Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Goldsboro",
            "state": "NC",
            "postal_code": "275341601",
            "country_code": "US",
            "telephone_number": "919-735-4736 x302",
            "fax_number": "919-735-6825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "118 Oakmont Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278585936",
            "country_code": "US",
            "telephone_number": "252-493-6525",
            "fax_number": "855-492-1625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOVA IC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-08",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "919-734-8803"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychoanalyst",
            "state": "NC",
            "license": "2518",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NC",
            "license": "0715",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005336",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004079",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "34782",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006439",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.