NPIMap

Organization Active NPI

Wayne County EMS

  • State or Local Public Health Clinic/Center
  • Goldsboro, NC
National Provider Identifier
1962541367
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
License
7221 Issued in NC
Legal business name
WAYNE COUNTY EMS
Practice address
301 N Herman St
Goldsboro, NC 27530-2973
Phone
(919) 731-1000
Fax
(919) 731-1232
NPI assigned
Feb 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Authorized official

Name
Mr. Davin Madden
Title
Health Director
Phone
(919) 705-1934

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 7221 NC
State or Local Public Health Clinic/Center 261QP0905X 7221 NC Primary
Clinic Pharmacy 3336C0002X 03873 NC

Addresses

Primary practice location

301 N Herman St
Goldsboro, NC 27530-2973

Mailing address

301 N Herman St
Box CC
Goldsboro, NC 27530-2973
Phone (919) 731-1000

Other names 1

  • Wayne County Health Department - IMM Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060509000371 NC Part B Supplier - Clinic/Group Practice 1759392517 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Goldsboro, NC

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585785600000",
    "number": "1962541367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N HERMAN ST",
            "address_2": "BOX CC",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275302973",
            "telephone_number": "919-731-1000",
            "fax_number": "919-731-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N HERMAN ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275302973",
            "telephone_number": "919-731-1000",
            "fax_number": "919-731-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE COUNTY EMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A",
        "authorized_official_last_name": "MADDEN",
        "authorized_official_first_name": "DAVIN",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "919-705-1934",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NC",
            "license": "7221",
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "NC",
            "license": "7221",
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NC",
            "license": "03873",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wayne County Health Department - IMM",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Wayne County Health Department - IMM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.