NPIMap

Organization Active NPI

Mid-State Health Systems, Inc

  • Community/Behavioral Health Agency
  • Hope Mills, NC
National Provider Identifier
1992865851
Registry record updated Oct 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL-026-199 Issued in NC
Legal business name
MID-STATE HEALTH SYSTEMS, INC
Practice address
3721 Legion Rd
Hope Mills, NC 28348-8411
Phone
(910) 484-3717
Fax
(910) 484-1315
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2007

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

Authorized official

Name
Sera Gilmore
Title
Administrator
Phone
(910) 484-3717

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X MHL-026-199 NC
Community/Behavioral Health Agency 251S00000X MHL-026-199 NC Primary

Addresses

Primary practice location

3721 Legion Rd
Hope Mills, NC 28348-8411

Mailing address

PO Box 64724
Fayetteville, NC 28306-0724
Phone (910) 484-3717

Other identifiers 1

IdentifierTypeStateIssuer
3408660MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Mid-State Health Systems Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193443200000",
    "number": "1992865851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64724",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283060724",
            "telephone_number": "910-484-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 LEGION RD",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283488411",
            "telephone_number": "910-484-3717",
            "fax_number": "910-484-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-STATE HEALTH SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-10-27",
        "status": "A",
        "authorized_official_last_name": "GILMORE",
        "authorized_official_first_name": "SERA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-484-3717"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": "MHL-026-199",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-026-199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408660",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hope Mills, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.