NPIMap

Organization Active NPI

Mid-State Health Systems, Inc

  • Community/Behavioral Health Agency
  • Kenansville, NC
National Provider Identifier
1679762066
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MID-STATE HEALTH SYSTEMS, INC
Practice address
117 Beasley St, 2ND Floor
Kenansville, NC 28349
Phone
(910) 296-9822
NPI assigned
Oct 22, 2007
Last updated
Oct 22, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Authorized official

Name
Sera Gilmore
Title
Administrator
Phone
(910) 484-3717

Specialties & licenses 1

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

Addresses

Primary practice location

117 Beasley St, 2ND Floor
Kenansville, NC 28349

Mailing address

PO Box 64724
Fayetteville, NC 28306-0724
Phone (910) 484-3717

National Provider Directory

National Provider Directory
Tax ID family
Mid-State Health Systems Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

117 Beasley St
Fl 2
Kenansville, NC 28349
Phone (910) 296-9822

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1679762066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64724",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283060724",
            "telephone_number": "910-484-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 BEASLEY ST, 2ND FLOOR",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "28349",
            "telephone_number": "910-296-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-STATE HEALTH SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "GILMORE",
        "authorized_official_first_name": "SERA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-484-3717"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenansville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.

Verify at the official NPI Registry.