NPIMap

Organization Active NPI

Comserv, Inc.

  • Community/Behavioral Health Agency
  • Shelby, NC
National Provider Identifier
1609909662
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMSERV, INC.
Practice address
112 E Dixon Blvd
Shelby, NC 28152
Phone
(704) 487-9806
NPI assigned
Mar 13, 2007
Organization subpart
Yes
Parent organization
COMSERV, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Authorized official

Name
Miss Dawn Kelley
Title
Ceo
Phone
(828) 325-4926

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

112 E Dixon Blvd
Shelby, NC 28152

Mailing address

619 Pennton Ave SW
Lenoir, NC 28645-5743
Phone (828) 757-0209

Other identifiers 2

IdentifierTypeStateIssuer
8300946MedicaidNC
8300946BMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Comservinc13 organizations share this tax ID, including this one
Part of
Comservinc

Other organizations with this tax ID 12

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

Locations

112 E Dixon Blvd
Shelby, NC 28152
Phone (704) 487-9806

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531699200000",
    "number": "1609909662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 PENNTON AVE SW",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455743",
            "telephone_number": "828-757-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E DIXON BLVD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "28152",
            "telephone_number": "704-487-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMSERV, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMSERV, INC.",
        "enumeration_date": "2007-03-13",
        "last_updated": "2018-07-16",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "828-325-4926",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300946",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300946B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; 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.