Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

NOVA IC, INC.
NPI 1043459852
Intermediate Care Facility, Intellectual Disabilities in Goldsboro, NC

Q: What is Nova Ic, Inc.'s NPI number?

The NPI number for Nova Ic, Inc. is 1043459852. It was assigned to this organization in the NPPES registry on February 18, 2009. The provider is also known as Holly street Home.

Q: What is Nova Ic, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Q: When was this NPI record last updated?

The NPPES record for Nova Ic, Inc. was last updated on September 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 18, 2009

1509 E HOLLY ST, GOLDSBORO, NC 27530(919) 734-8803(919) 735-6825 Get Directions Write a Review

NPPES record last updated: September 23, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

Record update history: Sep 23, 2026, Oct 8, 2025, Sep 30, 2024 and 4 more (7 updates tracked since 2015).

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About Nova Ic, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NOVA IC, INC. (NPI 1043459852) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Goldsboro, North Carolina and active in the NPI registry since February 2009. The organization lists Tracey Pridgen, Cfo, as its authorized official.

NPPES Registry Identity

NPI1043459852

Entity TypeOrganization

Primary Taxonomy315P00000X

Legal Business NameNOVA IC, INC.

Location Address1509 E HOLLY STGoldsboro, NC 27530-3033

Mailing AddressPo Box 11077Goldsboro, NC 27532-1077 · (919) 734-8803 · Fax (919) 735-6825

Phone(919) 734-8803

Fax(919) 735-6825

Organization SubpartNo

Authorized OfficialTracey PridgenCfo · (919) 734-8803

Enumeration DateFebruary 18, 2009

Last NPPES UpdateSeptember 23, 20267 updates tracked since enumeration

NPPES CertifiedSeptember 23, 2026

✔ NPI 1043459852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities

Taxonomy Code315P00000X

License✔ Licensed in NC · MHL-096-114

Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

1509 E HOLLY ST, Goldsboro, NC 27530

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Other Names 1

Other NameHolly Street Home

Other Identifiers 1

Medicaid3406312NC

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nova Ic, Inc.'s NPI number?

The NPI number for Nova Ic, Inc. is 1043459852. It was assigned to this organization in the NPPES registry on February 18, 2009. The provider is also known as Holly street Home.

Where is Nova Ic, Inc. located?

Nova Ic, Inc. is located at 1509 E Holly St, Goldsboro, NC 27530. The listed phone number is (919) 734-8803.

What is Nova Ic, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Nova Ic, Inc. was last updated on September 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.