NPIMap

Organization Active NPI

Port Health Services

  • Community/Behavioral Health Agency
  • Jacksonville, NC
National Provider Identifier
1962913327
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PORT HEALTH SERVICES
Practice address
224 Memorial Dr Ste B
Jacksonville, NC 28546-6332
Phone
(252) 830-7540
NPI assigned
Oct 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Authorized official

Name
Toyette Anthony
Title
Benefits and Credentialing Spec
Phone
(252) 830-7561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

224 Memorial Dr Ste B
Jacksonville, NC 28546-6332

Mailing address

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

Other names 1

  • PORT Human Services Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050726001211 NC Part B Supplier - Clinic/Group Practice 5193752681 Receives reassigned benefits from 43 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wilmington, NC; Whiteville, NC; Washington, NC; Rocky Mount, NC; New Bern, NC; Nags Head, NC; Morehead City, NC; Kinston, NC…

Other NPIs on the same Medicare enrollment 18

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

View all 18

National Provider Directory

National Provider Directory

Locations

224 Memorial Dr
#B
Jacksonville, NC 28546
Phone (252) 830-7540

NPI Registry JSON

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507766400000",
    "number": "1962913327",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 MEMORIAL DR STE B",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466332",
            "telephone_number": "252-830-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-12",
        "last_updated": "2017-10-12",
        "status": "A",
        "authorized_official_last_name": "ANTHONY",
        "authorized_official_first_name": "TOYETTE",
        "authorized_official_title_or_position": "BENEFITS AND CREDENTIALING SPEC",
        "authorized_official_telephone_number": "252-830-7561"
    },
    "taxonomies": [
        {
            "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"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; 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.