Support Incorporated

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MHL-036-292 Issued in NC

Legal business name

SUPPORT INCORPORATED

Practice address

708 S Chestnut St
Gastonia, NC 28054-4548

Phone

(704) 865-3525

Fax

(704) 865-3520

NPI assigned

Apr 18, 2011

Organization subpart

No

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

Authorized official

Name

Josh Martin

Title

Executive Director

Phone

(704) 865-3529

Specialties & licenses 13

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Support Incorporated

  • Community/Behavioral Health Agency
  • Gastonia, NC
  • NPI 1154366649

  O20050916000667

  Same enrollment

Locations

Practitioners 7

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

• Jessica Madeline Barnes

  • Clinical Social Worker
  • Gastonia, NC
  • NPI 1881148039
  Medicare reassignment NPD
• Montesha Sherrelle Evans, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gastonia, NC
  • NPI 1336693159
  Medicare reassignment NPD
• Peter Christian Mattfeld, PA-C

  • Physician Assistant
  • Gastonia, NC
  • NPI 1598120438
  Medicare reassignment NPD
• Karen L Melendez, M.D.

  • Psychiatry Physician
  • Statesville, NC
  • NPI 1184675977
  Medicare reassignment NPD
• Tanya Ann Pratt-Doctry, PA-C

  • Physician Assistant
  • Gastonia, NC
  • NPI 1699965624
  Medicare reassignment NPD
• Stephanie Nicole Hilderbran

  • Psychiatric/Mental Health Nurse Practitioner
  • Gastonia, NC
  • NPI 1164011359
  Medicare reassignment
• Samantha Ann Ryan

  • Clinical Social Worker
  • Gastonia, NC
  • NPI 1699269977
  NPD

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451433600000",
    "number": "1780974253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4003",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280540041",
            "telephone_number": "704-865-3525",
            "fax_number": "704-865-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 S CHESTNUT ST",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544548",
            "telephone_number": "704-865-3525",
            "fax_number": "704-865-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORT INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-18",
        "last_updated": "2015-12-30",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-865-3529"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-036-292",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8303341",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918314",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "016V4",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005063",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunshine Care Agency Inc
• Sunshine Care LLC
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• Support Inc.
• Support Incorporated
• Support Incorporated
• Supportive Solutions, LLC
• Susan M. McKinley, DDS, PA
• Christina Hilton Suttle, FNP-C
• Shaun Suttles

• Community/Behavioral Health Agency in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.