NPIMap

Organization Active NPI

Southlight Healthcare

  • Community/Behavioral Health Agency
  • Raleigh, NC
National Provider Identifier
1962556803
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SOUTHLIGHT HEALTHCARE
Practice address
2101 Garner Rd
Raleigh, NC 27610-0114
Phone
(919) 787-6131
Fax
(919) 571-2932
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Authorized official

Name
Adam Hartzell
Title
Ceo
Phone
(919) 787-6131

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Multi-Specialty Clinic/Center 261QM1300X
Methadone Clinic 261QM2800X

Addresses

Primary practice location

2101 Garner Rd
Raleigh, NC 27610-0114

Mailing address

3125 Poplarwood CT Ste 203
Raleigh, NC 27604-6445
Phone (919) 787-6131

Other practice location 1

3117 Poplarwood Ct Ste 115
Raleigh, NC 27604-1040
Phone (919) 787-6131

Other identifiers 4

IdentifierTypeStateIssuer
5901811MedicaidNC
8300533OtherMULT SPECIALTY ANNOUNCE
07197OtherNCBCBS
6005404OtherNCMCAID

Other names 1

  • Pathways Other name

National Provider Directory

National Provider Directory
Tax ID family
Southlight 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.

Locations

2809 Highwoods Blvd
Ste 103
Raleigh, NC 27604
Phone (919) 872-3713

3125 Poplarwood Ct
#303
Raleigh, NC 27604

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1962556803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 POPLARWOOD CT STE 203",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276046445",
            "telephone_number": "919-787-6131",
            "fax_number": "919-571-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 GARNER RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276100114",
            "telephone_number": "919-787-6131",
            "fax_number": "919-571-2932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3117 Poplarwood Ct Ste 115",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276041040",
            "country_code": "US",
            "telephone_number": "919-787-6131",
            "fax_number": "919-571-2932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHLIGHT HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2022-12-13",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "HARTZELL",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-787-6131"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901811",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULT SPECIALTY ANNOUNCE",
            "identifier": "8300533",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "07197",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCAID",
            "identifier": "6005404",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pathways",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.