NPIMap

Organization Active NPI

Primary Health Choice, Inc.

  • Community/Behavioral Health Agency
  • Raeford, NC
National Provider Identifier
1821290677
Registry record updated Mar 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PRIMARY HEALTH CHOICE, INC.
Practice address
755 S Main St
Raeford, NC 28376-3238
Phone
(910) 875-1485
Fax
(910) 875-1567
NPI assigned
Jun 4, 2007
Last updated
Mar 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2014

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

Authorized official

Name
Mr. Thad J. DavisNPI 1326173840
Title
Director
Phone
(910) 865-3500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

755 S Main St
Raeford, NC 28376-3238

Mailing address

PO Box 159
Saint Pauls, NC 28384-0159
Phone (910) 865-3500

Other identifiers 4

IdentifierTypeStateIssuer
2802374GMedicaidNC
8302374HMedicaidNC
8302374MedicaidNC
8302374RMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090916000431 NC Part B Supplier - Clinic/Group Practice 3173679180 Receives reassigned benefits from 4 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winston Salem, NC; Wilson, NC; Whiteville, NC; Shelby, NC; Sanford, NC; Salisbury, NC; Rocky Mount, NC; Red Springs, NC…

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Primary Health Choice Inc36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

Practitioners & affiliated clinicians

Practitioners 1

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": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393804800000",
    "number": "1821290677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 159",
            "city": "SAINT PAULS",
            "state": "NC",
            "postal_code": "283840159",
            "telephone_number": "910-865-3500",
            "fax_number": "910-865-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S MAIN ST",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283763238",
            "telephone_number": "910-875-1485",
            "fax_number": "910-875-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY HEALTH CHOICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2014-03-03",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "THAD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-865-3500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2802374G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302374H",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302374",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302374R",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raeford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.