WILMINGTON HEALTH ACCESS FOR TEENS
NPI 1790093094
Dietitian, Registered in Wilmington, NC
NPI Status: Active since September 21, 2010
Contact Information
4005 OLEANDER DR
WILMINGTON, NC
ZIP 28403
Phone: (910) 790-9949
Fax: (910) 790-9455
- Organization
- Dietitian, Registered
- CLIA Number: 34D0923036
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 12-12-2026
About WILMINGTON HEALTH ACCESS FOR TEENS
This page provides the complete NPI Profile along with additional information for Wilmington Health Access For Teens, a provider established in Wilmington, North Carolina operating as a Dietitian, Registered. The healthcare provider is registered in the NPI registry with number 1790093094 assigned on September 2010. The practitioner's primary taxonomy code is 133V00000X with license number L003170 (NC). The provider is registered as an organization and their NPI record was last updated 15 years ago. Wilmington Health Access For Teens operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Maria G Van De Bovenkamp (Director Of Administration)
- NPI
- 1790093094
- Provider Name
- WILMINGTON HEALTH ACCESS FOR TEENS
- Entity Type
- Organization
- Location Address
- 4005 OLEANDER DR WILMINGTON, NC 28403
- Location Phone
- (910) 790-9949
- Location Fax
- (910) 790-9455
- Mailing Address
- 4005 OLEANDER DR WILMINGTON, NC 28403
- Mailing Phone
- (910) 790-9949
- Mailing Fax
- (910) 790-9455
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-21-2010
- Last Update Date
- 09-21-2010
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dietitian, Registered
- Taxonomy Code
- 133V00000X
- Type
- Dietary & Nutritional Service Providers
- License No.
- L003170
- License State
- NC
- Taxonomy Description
- A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0108Q | OTHER (01) | NC | BCBS |
| 2344516 | MEDICARE UPIN (02) | NC | |
| 890108Q | MEDICAID (05) | NC |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D0923036
- Facility Type
- Community Clinic
- Certificate Effective Date
- December 13, 2024
- Certificate Expiration Date
- December 12, 2026
- Laboratory Director
- JENNIFER M. NOMIDES
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Wilmington Health Access For Teens in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
Reviews for WILMINGTON HEALTH ACCESS FOR TEENS
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 9 | 0 | 0 | 9 | 3 | 0 | 9 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 18 | 0 | 0 | 9 | 6 | 0 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 8 + 0 + 0 + 9 + 6 + 0 + 1 + 8 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1790093094 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1790788024 | MS. DONNA WHITE BASS NP Individual | Nurse Practitioner (Obstetrics & Gynecology) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1447252515 | JEFF TAYLOE LPC Individual | Counselor (Mental Health) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1154325116 | MELANY TARR LCSW Individual | Counselor (Mental Health) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1588620157 | WILMINGTON HEALTH ACCESS FOR TEENS, INC Organization | Clinic/Center (Primary Care) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9944 |
| 1558388140 | SALLY P CUMMINGS FNP-C Individual | Nurse Practitioner (Family) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1568561207 | WILMINGTON HEALTH ACCESS FOR TEENS, INC Organization | Family Medicine (Adolescent Medicine) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 772-5552 |
| 1902905649 | WILMINGTON HEALTH ACCESS FOR TEENS, INC Organization | Family Medicine (Adolescent Medicine) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1205980174 | MRS. KERRIE E MILLER RD, LDN Individual | Dietitian, Registered | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1225214919 | KIM MEYER PA-C Individual | Physician Assistant (Medical) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 763-4988 |
| 1841460755 | WILMINGTON HEALTH ACCESS FOR TEENS, INC Organization | Family Medicine (Adolescent Medicine) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1104057371 | MRS. AMY SUE VALIMONT LCSW Individual | Social Worker (Clinical) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1538414438 | LANEY WELLNESS CENTER Organization | Family Medicine (Adolescent Medicine) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1225393606 | RENEE SANDERS CROWGEY LPC, PLCAS Individual | Counselor (Mental Health) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1144664889 | MS. KELLI RENEE KELDERHOUSE FNP Individual | Family Medicine (Adolescent Medicine) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1821421405 | MICHELLE G COOPER RD Individual | Dietitian, Registered | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1861821613 | MARCIA BITTNER LCSW Individual | Social Worker (Clinical) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1447608575 | COASTAL HORIZONS CENTER, INC. Organization | Family Medicine | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1528367984 | MRS. KRISTEN TRUTT WILLIAMSON LCSW Individual | Social Worker (Clinical) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1679907851 | AUDREY KEETON Individual | Social Worker (Clinical) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
| 1790172153 | MEGHAN HELEN BLAIR LCMHCA Individual | Counselor (Professional) | 4005 OLEANDER DR WILMINGTON, NC 28403 (910) 790-9949 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790093094, enumerated in the NPI registry as an "organization" on September 21, 2010
The provider is located at 4005 Oleander Dr Wilmington, Nc 28403 and the phone number is (910) 790-9949
This medical organization specializes in Dietitian, Registered with taxonomy code 133V00000X
The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 34D0923036 for a "community clinic" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on September 21, 2010. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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