Active NPI
Wilmington Health Access for Teens, Inc
- Adolescent Medicine (Family Medicine) Physician
- Wilmington, NC
National Provider Identifier
1902905649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adolescent Medicine (Family Medicine) Physician
- Legal business name
- WILMINGTON HEALTH ACCESS FOR TEENS, INC
- Doing business as
- New Hanover High School Wellness Center
- Practice address
- 4005 Oleander Dr
Wilmington, NC 28403-6816 - Phone
- (910) 790-9949
- Fax
- (910) 790-9455
- NPI assigned
- Sep 21, 2006
- Organization subpart
- Yes
- Parent organization
- WILMINGTON HEALTH ACCESS FOR TEENS, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Maria G Van de Bovenkamp, CMA (AAMA)
- Title
- Director of Administration
- Phone
- (910) 790-9949
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent Medicine (Family Medicine) Physician | 207QA0000X | Primary |
Addresses
Primary practice location
4005 Oleander Dr
Wilmington, NC 28403-6816
Mailing address
1307 Market St
Wilmington, NC 28401-4331
Phone (910) 763-4988
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8701705 | Medicaid | NC |
Other names 1
- New Hanover High School Wellness Center
National Provider Directory
National Provider Directory- Part of
- Wilmington Health Access for Teens
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1288224000000",
"number": "1902905649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1307 MARKET ST",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284014331",
"telephone_number": "910-763-4988",
"fax_number": "910-763-4990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4005 OLEANDER DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284036816",
"telephone_number": "910-790-9949",
"fax_number": "910-790-9455"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILMINGTON HEALTH ACCESS FOR TEENS, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WILMINGTON HEALTH ACCESS FOR TEENS, INC",
"enumeration_date": "2006-09-21",
"last_updated": "2010-10-28",
"status": "A",
"authorized_official_last_name": "VAN DE BOVENKAMP",
"authorized_official_first_name": "MARIA",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
"authorized_official_telephone_number": "910-790-9949",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "CMA (AAMA)"
},
"taxonomies": [
{
"code": "207QA0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine, Adolescent Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8701705",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "New Hanover High School Wellness Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Wilmington, NC
- Wilmington Health Access for Teens, Inc
- Wilmington Health Access for Teens, Inc
- Wilmington Health Access for Teens, Inc
- Wilmington Health Access for Teens, Inc
- Wilmington Health Access for Teens, Inc
- Wilmington Health PLLC
- Wilmington Health PLLC
- Wilmington Health PLLC
- Wilmington Health PLLC
- Wilmington Health PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.