NPIMap

Organization Active NPI

Belmont Psychiatry & Counseling Services PLLC

Doing business as Serenity Psychiatric & Counseling Services

  • Physician Assistant
  • Cornelius, NC
National Provider Identifier
1609481704
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
BELMONT PSYCHIATRY & COUNSELING SERVICES PLLC
Doing business as
Serenity Psychiatric & Counseling Services
Practice address
16930 W Catawba Ave Ste 200
Cornelius, NC 28031-5639
Phone
(704) 322-4020
Fax
(704) 282-3018
NPI assigned
Sep 15, 2020
Last updated
Feb 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Authorized official

Name
Mr. Phil Orb Johns Jr., PA-CNPI 1841432549
Title
Owner/Employee
Phone
(704) 430-6268

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

16930 W Catawba Ave Ste 200
Cornelius, NC 28031-5639

Mailing address

210 N Church St Unit 1309
Charlotte, NC 28202-2266
Phone (704) 430-6268

Other names 1

  • Serenity Psychiatric & Counseling Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260430000748 NC Part B Supplier - Clinic/Group Practice 9638646391 Receives reassigned benefits from 1 practitioner
Practice locations: Cornelius, NC

National Provider Directory

National Provider Directory

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": "1600128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1609481704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N CHURCH ST UNIT 1309",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022266",
            "telephone_number": "704-430-6268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16930 W CATAWBA AVE STE 200",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315639",
            "telephone_number": "704-322-4020",
            "fax_number": "704-282-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELMONT PSYCHIATRY & COUNSELING SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-15",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "JOHNS",
        "authorized_official_first_name": "PHIL",
        "authorized_official_middle_name": "ORB",
        "authorized_official_title_or_position": "OWNER/EMPLOYEE",
        "authorized_official_telephone_number": "704-430-6268",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Psychiatric & Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.