NPIMap

Organization Active NPI

Pride in North Carolina, LLC

  • Community/Behavioral Health Agency
  • Greenville, NC
National Provider Identifier
1760420186
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PRIDE IN NORTH CAROLINA, LLC
Practice address
231 Commerce St
Greenville, NC 27858-5029
Phone
(252) 321-8080
NPI assigned
Jun 4, 2006
Last updated
Aug 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Authorized official

Name
Mr. Jason Rutski
Title
Director of Business Operations
Phone
(910) 452-1460

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary
Community/Behavioral Health Agency 251S00000X NC
Adult Mental Health Clinic/Center 261QM0850X MHL-067-186 NC
Adult Mental Health Clinic/Center 261QM0850X NC

Addresses

Primary practice location

231 Commerce St
Greenville, NC 27858-5029

Mailing address

231 Commerce St
Greenville, NC 27858-5029
Phone (252) 321-8080

Other practice location 1

2416 Bedgood Dr SW
Wilson, NC 27893-8515
Phone (252) 265-9200

Other practice location 2

5710 Oleander Dr Ste 110
Wilmington, NC 28403-4722
Phone (910) 769-1785

Other practice location 3

5710 Oleander Dr Ste 208
Wilmington, NC 28403-4722
Phone (910) 769-1785

Other practice location 4

901 N Winstead Ave Ste 260
Rocky Mount, NC 27804-8757
Phone (252) 210-6530

Other practice location 5

7610 Falls Of Neuse Rd Ste 290
Raleigh, NC 27615-3307
Phone (919) 321-9702

Other practice location 6

2902 N Herritage St Ste A
Kinston, NC 28501-1580
Phone (252) 686-5020

Other practice location 7

3886 Henderson Dr
Jacksonville, NC 28546-5219
Phone (910) 938-9833

Other practice location 8

208 Malloy St Ste B
Goldsboro, NC 27534-4478
Phone (984) 520-6080

Other practice location 9

1540 Purdue Dr Ste 100
Fayetteville, NC 28303-5509
Phone (910) 900-4660

Other practice location 10

407 S Griffin St Ste J
Elizabeth City, NC 27909-4693
Phone (252) 331-0322

Other practice location 11

1400 West Church Street Ext.
Elizabeth City, NC 27909-4510
Phone (252) 331-0322

Other practice location 12

1319 N Brightleaf Blvd Ste F
Smithfield, NC 27577-4876
Phone (919) 934-1312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050711000558 NC Part B Supplier - Clinic/Group Practice 9638105869 Receives reassigned benefits from 70 practitioners
3 other NPIs on this enrollment
Practice locations: Raleigh, NC; Wilson, NC; Wilmington, NC; Smithfield, NC; Jacksonville, NC; Greenville, NC; Goldsboro, NC; Fayetteville, NC…

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

407 S Griffin St
Ste J
Elizabeth City, NC 27909
Phone (252) 331-0322

208 Malloy St
Ste B
Goldsboro, NC 27534
Phone (984) 520-6080

1319 N Brightleaf Blvd
Ste F
Smithfield, NC 27577
Phone (919) 934-1312

5710 Oleander Dr
Ste 110
Wilmington, NC 28403
Phone (910) 769-1785

Practitioners & affiliated clinicians

Practitioners 137

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.

View all 137

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1760420186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 COMMERCE ST",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585029",
            "telephone_number": "252-321-8080",
            "fax_number": "252-321-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 COMMERCE ST",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585029",
            "telephone_number": "252-321-8080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2416 Bedgood Dr SW",
            "address_purpose": "LOCATION",
            "city": "Wilson",
            "state": "NC",
            "postal_code": "278938515",
            "country_code": "US",
            "telephone_number": "252-265-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5710 Oleander Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284034722",
            "country_code": "US",
            "telephone_number": "910-769-1785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5710 Oleander Dr Ste 208",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284034722",
            "country_code": "US",
            "telephone_number": "910-769-1785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 N Winstead Ave Ste 260",
            "address_purpose": "LOCATION",
            "city": "Rocky Mount",
            "state": "NC",
            "postal_code": "278048757",
            "country_code": "US",
            "telephone_number": "252-210-6530",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7610 Falls Of Neuse Rd Ste 290",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276153307",
            "country_code": "US",
            "telephone_number": "919-321-9702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2902 N Herritage St Ste A",
            "address_purpose": "LOCATION",
            "city": "Kinston",
            "state": "NC",
            "postal_code": "285011580",
            "country_code": "US",
            "telephone_number": "252-686-5020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3886 Henderson Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285465219",
            "country_code": "US",
            "telephone_number": "910-938-9833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "208 Malloy St Ste B",
            "address_purpose": "LOCATION",
            "city": "Goldsboro",
            "state": "NC",
            "postal_code": "275344478",
            "country_code": "US",
            "telephone_number": "984-520-6080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1540 Purdue Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283035509",
            "country_code": "US",
            "telephone_number": "910-900-4660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "407 S Griffin St Ste J",
            "address_purpose": "LOCATION",
            "city": "Elizabeth City",
            "state": "NC",
            "postal_code": "279094693",
            "country_code": "US",
            "telephone_number": "252-331-0322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 West Church Street Ext.",
            "address_purpose": "LOCATION",
            "city": "Elizabeth City",
            "state": "NC",
            "postal_code": "279094510",
            "country_code": "US",
            "telephone_number": "252-331-0322",
            "fax_number": "252-331-0320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1319 N Brightleaf Blvd Ste F",
            "address_purpose": "LOCATION",
            "city": "Smithfield",
            "state": "NC",
            "postal_code": "275774876",
            "country_code": "US",
            "telephone_number": "919-934-1312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIDE IN NORTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "RUTSKI",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "910-452-1460",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": "MHL-067-186",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.