NPIMap

Organization Active NPI

Primary Health Choice, Inc.

  • Community/Behavioral Health Agency
  • Dunn, NC
National Provider Identifier
1821372210
Registry record updated Feb 18, 2019
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
509 W Broad St
Dunn, NC 28334-4809
Phone
(910) 230-3760
NPI assigned
Oct 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2019

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

Authorized official

Name
Thad Davis
Title
Ceo
Phone
(910) 865-3500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X

Addresses

Primary practice location

509 W Broad St
Dunn, NC 28334-4809

Mailing address

PO Box 159
Saint Pauls, NC 28384-0159

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

Locations

509 W Broad St
Dunn, NC 28334
Phone (910) 230-3760

NPI Registry JSON

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550448000000",
    "number": "1821372210",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 W BROAD ST",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283344809",
            "telephone_number": "910-230-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY HEALTH CHOICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-04",
        "last_updated": "2019-02-18",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "THAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-865-3500"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunn, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; 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.