NPIMap

Organization Active NPI

Carolina Outreach, LLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
National Provider Identifier
1669858510
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CAROLINA OUTREACH, LLC
Practice address
5108 Reagan Dr Ste 13&14
Charlotte, NC 28206-3103
Phone
(704) 332-8787
NPI assigned
Aug 3, 2015
Organization subpart
Yes
Parent organization
CAROLINA OUTREACH, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Authorized official

Name
Timothy Brooks
Title
Co-Director
Phone
(919) 251-9001

Specialties & licenses 1

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

Addresses

Primary practice location

5108 Reagan Dr Ste 13&14
Charlotte, NC 28206-3103

Mailing address

5108 Reagan Dr Ste 13&14
Charlotte, NC 28206-3103
Phone (704) 332-8787

National Provider Directory

National Provider Directory
Tax ID family
Carolina Outreach LLC19 organizations share this tax ID, including this one
Part of
Carolina Outreach LLC

Other organizations with this tax ID 18

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

View all 18

Locations

5108 Reagan Dr
Ste 1314
Charlotte, NC 28206
Phone (704) 332-8787

NPI Registry JSON

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1669858510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5108 REAGAN DR STE 13&14",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282063103",
            "telephone_number": "704-332-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 REAGAN DR STE 13&14",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282063103",
            "telephone_number": "704-332-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA OUTREACH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINA OUTREACH, LLC",
        "enumeration_date": "2015-08-03",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CO-DIRECTOR",
        "authorized_official_telephone_number": "919-251-9001"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.