Sozo Health Pavilion, PA

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

28713 Issued in NC

Legal business name

SOZO HEALTH PAVILION, PA

Practice address

615 College St
Jacksonville, NC 28540-5310

Phone

(910) 455-7110

Fax

(910) 455-7938

NPI assigned

May 17, 2006

Last updated

Feb 28, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Phyllis Aycock Williams, R.N.NPI 1578612008

Title

Manager

Phone

(910) 455-7110

Specialties & licenses 10

Addresses

Locations

Practitioners 1

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.

• Phyllis Aycock Williams, R.N.

  • Home Health Registered Nurse
  • Jacksonville, NC
  • NPI 1578612008

  General Practice

  NPD (past) Authorized official

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298851200000",
    "number": "1538111414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7105",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285402105",
            "telephone_number": "910-455-7110",
            "fax_number": "910-455-7938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 COLLEGE ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285405310",
            "telephone_number": "910-455-7110",
            "fax_number": "910-455-7938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOZO HEALTH PAVILION, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2011-02-28",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "AYCOCK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "910-455-7110",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "28713",
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": "NC",
            "license": "28713",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": "NC",
            "license": "082155",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "28713",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NC",
            "license": "28713",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NC",
            "license": "28713",
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NC",
            "license": "28713",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NC",
            "license": "28713",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NC",
            "license": "28713",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "28713",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Adult Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2011; 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.