NPIMap

Organization Active NPI

Outlook Forensic & Behavioral Health

  • Psychiatry Physician
  • Concord, NC
National Provider Identifier
1891002952
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
200500827 Issued in NC
Legal business name
OUTLOOK FORENSIC & BEHAVIORAL HEALTH
Practice address
280 Executive Park Dr
Suite 100
Concord, NC 28025-1837
Phone
(704) 785-8282
Fax
(704) 785-8282
NPI assigned
Sep 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

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

Authorized official

Name
Dr. Jonathan Keith Stoudmire, M.D.
Title
President
Phone
(704) 841-3886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 200500827 NC Primary

Addresses

Primary practice location

280 Executive Park Dr
Suite 100
Concord, NC 28025-1837

Mailing address

280 Executive Park Dr
Suite 100
Concord, NC 28025-1837
Phone (704) 785-8282

Other identifiers 1

IdentifierTypeStateIssuer
5900927MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Outlook Forensic and Behavioral Health Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353456000000",
    "number": "1891002952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 EXECUTIVE PARK DR",
            "address_2": "SUITE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251837",
            "telephone_number": "704-785-8282",
            "fax_number": "704-785-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 EXECUTIVE PARK DR",
            "address_2": "SUITE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251837",
            "telephone_number": "704-785-8282",
            "fax_number": "704-785-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTLOOK FORENSIC & BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-09",
        "last_updated": "2012-11-21",
        "status": "A",
        "authorized_official_last_name": "STOUDMIRE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-841-3886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "200500827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900927",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.