NPIMap

Organization Active NPI

Positive Life Changes

  • Community/Behavioral Health Agency
  • Hookerton, NC
National Provider Identifier
1750603288
Registry record updated Oct 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
POSITIVE LIFE CHANGES
Practice address
210 E Main St
Hookerton, NC 28538-0000
Phone
(252) 557-0444
Fax
(252) 557-0445
NPI assigned
Feb 25, 2010
Last updated
Oct 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2018

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

Authorized official

Name
Shana MidgetteNPI 1659644383
Title
President/Program Supervisor
Phone
(252) 557-0444

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Community/Behavioral Health Agency 251S00000X NC
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

210 E Main St
Hookerton, NC 28538-0000

Mailing address

210 E Main St
Hookerton, NC 28538-0000
Phone (252) 557-0444

Other identifiers 1

IdentifierTypeStateIssuer
6112264MedicaidNC

National Provider Directory

National Provider Directory

Locations

210 E Main St
Hookerton, NC 28538
Phone (252) 557-0444

Practitioners & affiliated clinicians

Practitioners 2

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": "1267056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539820800000",
    "number": "1750603288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E MAIN ST",
            "city": "HOOKERTON",
            "state": "NC",
            "postal_code": "285380000",
            "telephone_number": "252-557-0444",
            "fax_number": "252-557-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E MAIN ST",
            "city": "HOOKERTON",
            "state": "NC",
            "postal_code": "285380000",
            "telephone_number": "252-557-0444",
            "fax_number": "252-557-0445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POSITIVE LIFE CHANGES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-25",
        "last_updated": "2018-10-18",
        "status": "A",
        "authorized_official_last_name": "MIDGETTE",
        "authorized_official_first_name": "SHANA",
        "authorized_official_title_or_position": "PRESIDENT/PROGRAM SUPERVISOR",
        "authorized_official_telephone_number": "252-557-0444"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6112264",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hookerton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.