OCTOBER ROAD INC
NPI 1376389940
Community/Behavioral Health in Jacksonville, NC
About October Road Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
OCTOBER ROAD INC (NPI 1376389940) is a healthcare organization registered as a community/behavioral health in Jacksonville, North Carolina and active in the NPI registry since July 2024. The organization holds a CLIA Waiver certificate valid through February 2, 2028 and lists Jason Hendricks, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
October Road Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
22Medicare enrollment records show 22 clinicians reassign Medicare billing to October Road Inc, which bills Medicare for the services they deliver. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 5
Nearest to this location (20)
See all 22Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 34D2337946
October Road Dba Pyramid Jacksonville Outpatient · Jacksonville, NCFrequently 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 October Road Inc's NPI number?
The NPI number for October Road Inc is 1376389940. It was assigned to this organization in the NPPES registry on July 3, 2024.
Where is October Road Inc located?
October Road Inc is located at 255 Williamsburg Pkwy, Jacksonville, NC 28546. The listed phone number is (828) 606-9013.
What is October Road Inc's specialty?
The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.
Is October Road Inc enrolled in Medicare?
Yes. October Road Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through October Road Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 22 clinicians in 5 Medicare specialties reassign their Medicare billing to October Road Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (11), Nurse Practitioner (6) and Mental Health Counselor (2). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does October Road Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 34D2337946) is associated with this NPI, valid through February 2, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does October Road Inc accept?
Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, Blue Cross and Blue Shield of NC and Cigna Healthcare list October Road Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for October Road Inc was last updated on April 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.
# October Road Inc · NPI 1376389940
Community/Behavioral Health organization in Jacksonville, North Carolina. Organization record, active in the CMS NPPES registry since July 3, 2024.
## Identity
- **NPI:** 1376389940 (Entity type: Organization)
- **Enumerated:** July 3, 2024
- **Primary specialty:** Community/Behavioral Health · taxonomy 251S00000X
- **Organization subpart:** No
- **Authorized official:** Jason Hendricks, CEO
## Practice location
- **Address:** 255 WILLIAMSBURG PKWY, Jacksonville, NC 28546-6856
- **Phone:** (828) 606-9013
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 22 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (11), Nurse Practitioner (6), Mental Health Counselor (2); [full list](https://npiprofile.com/npi/1376389940/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 4, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1376389940) · Data from the CMS NPPES public registry.