NPIMap

Organization Active NPI

Progressive Care Services Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Rocky Mount, NC
National Provider Identifier
1760620520
Registry record updated Jan 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
PROGRESSIVE CARE SERVICES INC
Practice address
3216 Zebulon Rd
Rocky Mount, NC 27804-2435
Phone
(252) 452-3302
NPI assigned
Jan 31, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2009

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

Authorized official

Name
Mr. Victor Randolph Moore Jr.
Title
Executive Director
Phone
(252) 452-3302

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NC Primary

Addresses

Primary practice location

3216 Zebulon Rd
Rocky Mount, NC 27804-2435

Mailing address

3216 Zebulon Rd
Rocky Mount, NC 27804-2435
Phone (252) 452-3302

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170105001241 NC Part B Supplier - Clinic/Group Practice 8022399096 Receives reassigned benefits from 4 practitioners
Practice locations: Rocky Mount, NC

National Provider Directory

National Provider Directory

Locations

2747 Sunset Ave
#109
Rocky Mount, NC 27804
Phone (252) 902-4099

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1233360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233360000000",
    "number": "1760620520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 ZEBULON RD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042435",
            "telephone_number": "252-452-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 ZEBULON RD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042435",
            "telephone_number": "252-452-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE CARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-31",
        "last_updated": "2009-01-31",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "RANDOLPH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "252-452-3302",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2009; 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.