WILMINGTON HEALTH ACCESS FOR TEENS


Address: 4005 Oleander Dr, Wilmington, NC 28403-6816
Phone: 9107909949

WILMINGTON HEALTH ACCESS FOR TEENS (NPI# 1790093094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1790093094
Entity Type Organization
Organization Name WILMINGTON HEALTH ACCESS FOR TEENS
Practice Address 4005 Oleander Dr
Wilmington
NC 28403-6816
Practice Telephone 9107909949
Practice Fax Number 9107909455
Mailing Telephone 9107909949
Mailing Fax Number 9107909455
Enumeration Date 2010-09-21
Last Update Date 2010-09-21
Authorized Official Name MARIA G VAN DE BOVENKAMP (DIRECTOR OF ADMINISTRATION)
Authorized Official Telephone 9107909949
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 133V00000X Dietitian, Registered L003170 NC Dietary & Nutritional Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NC 890108Q 05
NC BCBS 0108Q 01

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1063547990 Wilmington Health Access for Teens Counselor 1805 S 13th St, Wilmington, NC 28401-6469 2007-02-22
1033245709 Wilmington Health Access for Teens Counselor 4005 Oleander Dr, Wilmington, NC 28403-6816 2007-02-26
1811022908 Wilmington Health Access for Teens Counselor 1307 Market St, Wilmington, NC 28401-4331 2007-02-22

Office Location

Street Address 4005 OLEANDER DR
City WILMINGTON
State NC
Zip Code 28403-6816

Providers in the same location

NPI Name Taxonomy Address Enumeration
1790788024 Donna White Bass Nurse Practitioner 4005 Oleander Dr, Wilmington, NC 28403-6816 2005-05-31
1225656663 Clayton Campbell Gruber Social Worker 4005 Oleander Dr, Wilmington, NC 28403-6816 2020-07-13
1417574500 Megan Shavon Bolden Social Worker 4005 Oleander Dr, Wilmington, NC 28403-6816 2020-07-06
1356973242 Josalin Hunter-jones Social Worker 4005 Oleander Dr, Wilmington, NC 28403-6816 2020-02-07
1053955294 Jennifer Ann Rendleman Social Worker 4005 Oleander Dr, Wilmington, NC 28403-6816 2019-10-31
1295244002 James Mckay Glasgow Social Worker 4005 Oleander Dr, Wilmington, NC 28403-6816 2017-09-25
1386199560 Anka Roberto Nurse Practitioner 4005 Oleander Dr, Wilmington, NC 28403 2016-08-17
1982055273 Coastal Horizons Center Inc. Counselor 4005 Oleander Dr, Wilmington, NC 28403-6816 2016-06-28
1447608575 Coastal Horizons Center, Inc. Family Medicine 4005 Oleander Dr, Wilmington, NC 28403-6816 2016-05-31
1790172153 Meghan Helen Blair Counselor 4005 Oleander Dr, Wilmington, NC 28403-6816 2015-04-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902413875 Ymca of Southeastern Nc Health Educator 2710 Market Street, Wilmington, NC 28403 2020-09-25
1659917334 Noa Alper Occupational Therapist 5412 Old Garden Road, Wilmington, NC 28403 2019-11-18
1992346340 Nancy Rosita Carson Technician 5608 Locke Str. Apt 108, Wilmington, NC 28403 2019-10-07
1912484585 Jennifer Nicole Perry Behavior Technician 349 Campus Cv, Wilmington, NC 28403 2018-07-25
1386159929 Monumental Foundations LLC Clinic/Center Plum Tree Plaza 925 South Kerr Ave Suite F4, Wilmington, NC 28403 2017-12-05
1114445731 Jacqulyn Craichy Speech-Language Pathologist 75 Cavalier Drive, Wilmington, NC 28403 2017-09-04
1730638545 Ashley Mcneil Durable Medical Equipment & Medical Supplies 3435 Wilshire Blvd Apt 203, Wilmington, NC 28403 2016-09-22
1306204276 Valerie Pringle Jones Physical Therapist 1717 Shipyard Blvd. Ste 350, Wilmington, NC 28403 2016-02-05
1689039992 Lifeline Treatment Center Clinic/Center 5710 Oleander Dr Ste 100, Wilmington, NC 28403 2015-12-31
1750758264 Melissa Beatson Speech-Language Pathologist 4014 Oleander Drive, Ste. 3b, Coastal Speech & Language Pllc, Wilmington, NC 28403 2015-09-01
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Taxonomy Information

Taxonomy Code 133V00000X
Grouping Dietary & Nutritional Service Providers
Classification Dietitian, Registered

Taxonomy Definition

A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration.
Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1659978245 Jaclyn Lee Atwater Dietitian, Registered 415 Yucca Ln, Wilmington, NC 28412-1042 2020-10-06
1912521626 Kenneth Jefferson Allen IIi Dietitian, Registered 2106 Barnett Ave, Wilmington, NC 28403-2240 2020-05-29
1720600729 Melissa Buscetta Dietitian, Registered 4647 Fairview Dr Apt 328, Wilmington, NC 28412-3684 2020-05-12
1285270207 Ruby Ali Dietitian, Registered 115 Amberleigh Dr Apt 206, Wilmington, NC 28411-9810 2019-11-25
1184280158 Melissa Danielle Flynn Dietitian, Registered 4702 Bentley Dr, Wilmington, NC 28409-6958 2019-05-15
1013424126 Kyrstin Brianna Draney Dietitian, Registered 5129 Oleander Dr Ste 103, Wilmington, NC 28403-7062 2018-01-10
1588191225 Rachael Swartz Dietitian, Registered 3305 Burnt Mill Dr Ste 100, Wilmington, NC 28403-3067 2017-05-12
1235663014 April Callahan Dietitian, Registered 2 Kristina Ct, Wilmington, DE 19808-4063 2017-04-18
1518416205 Nancy Lois Angell Dietitian, Registered 114 Kenneth Ct, Wilmington, NC 28405-1307 2016-09-23
1891163218 Stefanie Weiner Dietitian, Registered 919 Cloister Rd, Apt E, Wilmington, DE 19809-1018 2015-09-02
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Competitor

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City WILMINGTON
Zip Code 28403

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Dataset Information

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.

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