PORT HEALTH SERVICES (NPI# 1962913327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962913327 |
| Entity Type | Organization |
| Organization Name | PORT HEALTH SERVICES |
| Other Organization Name | PORT HUMAN SERVICES |
| Practice Address |
224 Memorial Dr Ste B Jacksonville NC 28546-6332 |
| Mailing Address |
4300 Sapphire Ct Ste 110 Greenville NC 27834-9079 |
| Practice Telephone | 2528307540 |
| Mailing Telephone | 2528307540 |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2017-10-12 |
| Authorized Official Name | TOYETTE ANTHONY (BENEFITS AND CREDENTIALING SPEC) |
| Authorized Official Telephone | 2528307561 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| PORT Human Services | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417356411 | Port Health Services | Counselor | 50347 Nc Hwy 12, Frisco, NC 27936 | 2014-08-15 |
| 1730505470 | Port Health Services | Community/Behavioral Health | 2206 Wrightsville Ave # A, Wilmington, NC 28403-2406 | 2014-03-05 |
| 1417293663 | Port Health Services | Counselor | 144b Community College Rd, Ahoskie, NC 27910-8047 | 2012-12-17 |
| 1245500909 | Port Health Services | Community/Behavioral Health | 2808 Croatan Hwy Suite B, Nags Head, NC 27959-9024 | 2012-01-11 |
| 1326331216 | Port Health Services | Community/Behavioral Health | 314 Progress Drive Extension, Burgaw, NC 28425-2813 | 2011-05-25 |
| 1902101496 | Port Health Services | Community/Behavioral Health | 1507 Martin Street, Wilmington, NC 28401-6422 | 2011-01-14 |
| 1497075618 | Port Health Services | Counselor | 4300-110 Sapphire Court, Greenville, NC 27834-9019 | 2010-06-10 |
| 1881822344 | Port Health Services | Counselor | 101 Arpdc St, Hertford, NC 27944-7901 | 2009-06-23 |
| 1518195072 | Port Health Services | Community/Behavioral Health | 102 Medical Dr Ste A&b, Elizabeth City, NC 27909-3361 | 2009-06-23 |
| 1396897161 | Port Health Services | Substance Abuse Rehabilitation Facility | 114 Health Drive, Greenville, NC 27834-7826 | 2007-01-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PORT HEALTH SERVICES | 4300 Sapphire Ct Ste 110, Greenville, NC 27834-9079 |
| Street Address |
224 MEMORIAL DR STE B |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-6332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427632 | Sunzup Counseling and Wellness | Community/Behavioral Health | 3355 Claire Ln Apt 1116, Jacksonville, FL 32223-6662 | 2020-11-02 |
| 1063043420 | Elephant Clinic Ltd. | Community/Behavioral Health | 8 Unf Dr # 221, Jacksonville, FL 32224-7699 | 2020-02-03 |
| 1679056857 | Inspire To Rise Inc. | Community/Behavioral Health | 4603 Silverthorn Dr, Jacksonville, FL 32258-2010 | 2018-09-13 |
| 1558863787 | Positive Development, LLC | Community/Behavioral Health | 3840 Belfort Rd Ste 302, Jacksonville, FL 32216-8210 | 2018-03-04 |
| 1073012555 | Pivotal Step Services, Pllc | Community/Behavioral Health | 1106b Gum Branch Rd, Jacksonville, NC 28540-5743 | 2018-02-09 |
| 1518473594 | Werp LLC | Community/Behavioral Health | 5291 Collins Rd Lot 293, Jacksonville, FL 32244-5389 | 2017-12-28 |
| 1871007062 | National Youth Advocate Program, Inc | Community/Behavioral Health | 2200 Rosselle St, Jacksonville, FL 32204-3126 | 2017-11-27 |
| 1598282667 | B.e.h. Elderly Care LLC | Community/Behavioral Health | 5145 Timuquana Rd Apt 6, Jacksonville, FL 32210-8923 | 2017-08-29 |
| 1427598689 | Family Farms of Northeast Florida | Community/Behavioral Health | 16844 Ethel Rd, Jacksonville, FL 32218-1108 | 2017-03-06 |
| 1366992562 | A Brighter Future Counseling, Pllc | Community/Behavioral Health | 308 Clint Rd, B, Jacksonville, AR 72076-3581 | 2016-10-12 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.