NPIMap

Organization Active NPI

Compass Adult Care, Inc.

  • Community/Behavioral Health Agency
  • Wilmington, NC
National Provider Identifier
1770768640
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMPASS ADULT CARE, INC.
Practice address
4000 Shipyard Blvd
Suite 130
Wilmington, NC 28403-6192
Phone
(704) 521-4977
Fax
(704) 521-8541
NPI assigned
Jan 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Authorized official

Name
Mr. Derek Bullard
Title
Ceo
Phone
(704) 521-4977

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4000 Shipyard Blvd
Suite 130
Wilmington, NC 28403-6192

Mailing address

PO Box 19649
Charlotte, NC 28219-9649

Other identifiers 3

IdentifierTypeStateIssuer
8301688MedicaidNC
8301688BMedicaidNC
8301688GMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Compass Adult Care Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4000 Shipyard Blvd
Ste 130
Wilmington, NC 28403
Phone (910) 763-3166

NPI Registry JSON

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1770768640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 SHIPYARD BLVD",
            "address_2": "SUITE 130",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036192",
            "telephone_number": "704-521-4977",
            "fax_number": "704-521-8541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASS ADULT CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "BULLARD",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-521-4977",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301688",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301688B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301688G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; 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.