NPIMap

Organization Active NPI

Whiteville Mat Services, Inc.

  • Methadone Clinic
  • Whiteville, NC
National Provider Identifier
1740868744
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
WHITEVILLE MAT SERVICES, INC.
Practice address
109 Leslie Newsome Ave
Whiteville, NC 28472-4937
Phone
(919) 889-5118
NPI assigned
Mar 31, 2021
Last updated
Mar 31, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Authorized official

Name
Dr. Grady B. Jefferys Jr., PH.D.
Title
President
Phone
(828) 173-1643

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU
Methadone Clinic 261QM2800X NU Primary

Addresses

Primary practice location

109 Leslie Newsome Ave
Whiteville, NC 28472-4937

Mailing address

109 Leslie Newsome Ave
Whiteville, NC 28472-4937
Phone (919) 889-5118

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1617148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617148800000",
    "number": "1740868744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 LESLIE NEWSOME AVE",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284724937",
            "telephone_number": "919-889-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 LESLIE NEWSOME AVE",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284724937",
            "telephone_number": "919-889-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITEVILLE MAT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "JEFFERYS",
        "authorized_official_first_name": "GRADY",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "828-173-1643",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.