Active NPI
People of Potential, Inc
- Community/Behavioral Health Agency
- Jacksonville, NC
National Provider Identifier
1487838520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- PEOPLE OF POTENTIAL, INC
- Practice address
- 1703 Country Club Rd
Suite 305
Jacksonville, NC 28546-6008 - Phone
- (901) 989-1224
- Fax
- (910) 938-0045
- NPI assigned
- Dec 26, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Dawn L McCullen
- Title
- Director
- Phone
- (910) 265-1756
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
1703 Country Club Rd
Suite 305
Jacksonville, NC 28546-6008
Mailing address
1703 Country Club Rd Ste 305
Jacksonville, NC 28546-6006
Phone (901) 989-1224
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8301274B | Medicaid | NC |
National Provider Directory
National Provider Directory- Tax ID family
- People of Potential Inc
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Jacksonville, NC
- NPI 1124132030
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Jacksonville, NC
- NPI 1366563777
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Jacksonville, NC
- NPI 1902928765
Locations
1703 Country Club Rd
Ste 305
Jacksonville, NC 28546
Phone (910) 619-2277
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198627200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1198627200000",
"number": "1487838520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1703 COUNTRY CLUB RD STE 305",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285466006",
"telephone_number": "901-989-1224",
"fax_number": "910-938-0045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1703 COUNTRY CLUB RD",
"address_2": "SUITE 305",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285466008",
"telephone_number": "901-989-1224",
"fax_number": "910-938-0045"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEOPLE OF POTENTIAL, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-26",
"last_updated": "2007-12-26",
"status": "A",
"authorized_official_last_name": "MCCULLEN",
"authorized_official_first_name": "DAWN",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "910-265-1756",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8301274B",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.