NPIMap

Organization Active NPI

Metropolitan Community Health Services, Inc

Doing business as Agape Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Williamston, NC
National Provider Identifier
1801222716
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
METROPOLITAN COMMUNITY HEALTH SERVICES, INC
Doing business as
Agape Community Health Center
Practice address
1130 Godwin Dr
Williamston, NC 27892-6828
Phone
(252) 789-0401
Fax
(252) 789-0452
NPI assigned
Sep 24, 2013
Last updated
Jun 3, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
METROPOLITAN COMMUNITY HEALTH SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Authorized official

Name
Laurence J Doby
Title
Office Manager
Phone
(252) 495-0155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

1130 Godwin Dr
Williamston, NC 27892-6828

Mailing address

PO Box 1886
Washington, NC 27889-1886
Phone (252) 789-0401

Other names 1

  • Agape Community Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040630000822 NC Part B Supplier - Clinic/Group Practice 9931010881 Receives reassigned benefits from 46 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Williamston, NC; Washington, NC; Plymouth, NC
O20141111002313 NC Part A Provider - Federally Qualified Health Center (FQHC) 9931010881 Practice locations: Williamston, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801222716. Details of each certification follow.

Federally qualified health center certification: CCN 341021

Legal name
METROPOLITAN COMMUNITY HEALTH SERVICES INC
Doing business as
AGAPE COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 11, 2014
Last certification
Nov 11, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 1, 2000 in NC
Enrollment address
1130 Godwin Dr
Williamston, NC 27892-6828

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Part of
Metropolitan Community Health Services Inc

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Laurence J Doby Individual Operational/Managerial ControlExecutive Director May 13, 2009 100%
Michael L McDuffie Individual Corporate OfficerChief Executive Officer Jun 23, 2014 100%
Metropolitan Community Health Services Inc Organization, Washington, NC Non-profit 5% Or Greater Direct Ownership Interest Jun 14, 2013 100%

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Agape Health Services- PlymouthPlymouth, NC, CCN 341174 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2022
Agape Health Services Mobile UnitWashington, NC, CCN 341179 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 1999
Agape Health Services - Carolina AvenueWashington, NC, CCN B61073 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 16, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1801222716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1886",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278891886",
            "telephone_number": "252-789-0401",
            "fax_number": "252-789-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 GODWIN DR",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278926828",
            "telephone_number": "252-789-0401",
            "fax_number": "252-789-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN COMMUNITY HEALTH SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METROPOLITAN COMMUNITY HEALTH SERVICES, INC",
        "enumeration_date": "2013-09-24",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "DOBY",
        "authorized_official_first_name": "LAURENCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "252-495-0155"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agape Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamston, NC

Sources for this page

Verify at the official NPI Registry.