Organization Active NPI

Community Prevention Services, Inc.

  • Community/Behavioral Health Agency
  • Jacksonville, NC
National Provider Identifier
1801489943
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY PREVENTION SERVICES, INC.
Practice address
918 Henderson Dr
Jacksonville, NC 28540-7420
Phone
(910) 353-0972
Fax
(910) 353-1439
NPI assigned
Feb 19, 2021
Last updated
May 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Authorized official

Name
Kelli Knapp, LCMHCNPI 1730627761
Title
Vice President
Phone
(910) 353-0972

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

918 Henderson Dr
Jacksonville, NC 28540-7420

Mailing address

918 Henderson Dr
Jacksonville, NC 28540-7420
Phone (910) 353-0972

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240520000364 NC Part B Supplier - Clinic/Group Practice 1254772429 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, NC

National Provider Directory

National Provider Directory

Locations

2444 Commerce Rd
Ste 110
Jacksonville, NC 28546

918 Henderson Dr
Jacksonville, NC 28540
Phone (910) 353-0972

918 Henderson Dr
#A
Jacksonville, NC 28540
Phone (910) 353-0972

Practitioners & affiliated clinicians

Practitioners 2

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": "1613692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1801489943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 HENDERSON DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285407420",
            "telephone_number": "910-353-0972",
            "fax_number": "910-353-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 HENDERSON DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285407420",
            "telephone_number": "910-353-0972",
            "fax_number": "910-353-1439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PREVENTION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-19",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "KNAPP",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "910-353-0972",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.