NPIMap

Organization Active NPI

Family Preservation Services of North Carolina, LLC

Doing business as Clarvida

  • Community/Behavioral Health Agency
  • Forest City, NC
National Provider Identifier
1760528913
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILY PRESERVATION SERVICES OF NORTH CAROLINA, LLC
Doing business as
Clarvida
Practice address
139 E Trade St
Forest City, NC 28043-3149
Phone
(828) 288-2707
NPI assigned
Jan 29, 2007
Last updated
Jul 15, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY PRESERVATION SERVICES OF NORTH CAROLINA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Melissa Kay Hedden
Title
Contract Manager
Phone
(828) 287-7945

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X NC
Community/Behavioral Health Agency 251S00000X MHL081068 NC
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

139 E Trade St
Forest City, NC 28043-3149

Mailing address

P.O. Box 759194
Baltimore, MD 21275-9194
Phone (828) 225-3100

Other identifiers 2

IdentifierTypeStateIssuer
8301843MedicaidNC
8301843SMedicaidNC

Other names 1

  • Clarvida Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070801000148 NC Part B Supplier - Clinic/Group Practice 7214028539 Receives reassigned benefits from 15 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hendersonville, NC; Forest City, NC; Columbus, NC; Charlotte, NC; Asheville, NC

Other NPIs on the same Medicare enrollment 25

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

View all 25

National Provider Directory

National Provider Directory
Part of
Family Preservation Services of North Carolina Inc - Brevard Middle

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1760528913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 759194",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212759194",
            "telephone_number": "828-225-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 E TRADE ST",
            "city": "FOREST CITY",
            "state": "NC",
            "postal_code": "280433149",
            "telephone_number": "828-288-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRESERVATION SERVICES OF NORTH CAROLINA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY PRESERVATION SERVICES OF NORTH CAROLINA, LLC",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "HEDDEN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "CONTRACT MANAGER",
        "authorized_official_telephone_number": "828-287-7945"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL081068",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301843",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301843S",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarvida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Forest City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.