NPIMap

Organization Active NPI

Port Health Services

  • Community/Behavioral Health Agency
  • Wilmington, NC
National Provider Identifier
1902101496
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PORT HEALTH SERVICES
Practice address
1507 Martin St
Wilmington, NC 28401-6483
Phone
(910) 251-8944
Fax
(910) 251-6200
NPI assigned
Jan 14, 2011
Last updated
May 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Authorized official

Name
Brett Beavers
Title
Credentialing Manager
Phone
(919) 210-7661

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1507 Martin St
Wilmington, NC 28401-6483

Mailing address

4300 Sapphire CT Ste 110
Greenville, NC 27834-9079
Phone (252) 830-7540

Other practice location 1

416 Walnut St
Wilmington, NC 28401-4033
Phone (910) 762-1743

Other names 1

  • PORT Human Services Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Port Health Services38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

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

View all 37

Locations

416 Walnut St
Wilmington, NC 28401
Phone (910) 762-1743

NPI Registry JSON

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

{
    "created_epoch": "1294963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1902101496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 SAPPHIRE CT STE 110",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278349079",
            "telephone_number": "252-830-7540",
            "fax_number": "252-413-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 MARTIN ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016483",
            "telephone_number": "910-251-8944",
            "fax_number": "910-251-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "416 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284014033",
            "country_code": "US",
            "telephone_number": "910-762-1743",
            "fax_number": "910-762-2921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PORT HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-14",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "BEAVERS",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "919-210-7661"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PORT Human Services",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "PORT Human Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.