NPIMap

Organization Active NPI

Potter'S House of Beaufort County, Inc.

  • Community/Behavioral Health Agency
  • Washington, NC
National Provider Identifier
1932394632
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL 007 031 Issued in NC
Legal business name
POTTER'S HOUSE OF BEAUFORT COUNTY, INC.
Practice address
319 E 11TH St
Washington, NC 27889-3716
Phone
(252) 946-6390
Fax
(252) 946-3847
NPI assigned
Sep 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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

Authorized official

Name
Mrs. Tonya Woolard
Title
Owner/Director
Phone
(252) 946-6390

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL 007 031 NC Primary

Addresses

Primary practice location

319 E 11TH St
Washington, NC 27889-3716

Mailing address

405 N Market St
Washington, NC 27889-4935
Phone (252) 946-6390

Other identifiers 1

IdentifierTypeStateIssuer
6603383MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Potter'S House of Beaufort County Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189036800000",
    "number": "1932394632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N MARKET ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278894935",
            "telephone_number": "252-946-6390",
            "fax_number": "252-946-3847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 E 11TH ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893716",
            "telephone_number": "252-946-6390",
            "fax_number": "252-946-3847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTER'S HOUSE OF BEAUFORT COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A",
        "authorized_official_last_name": "WOOLARD",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "252-946-6390",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL 007 031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603383",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.