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Port South Village

Assisted Living Facility in Wilmington, NC · enumerated 2007 · authorized official Buddy Lockamy, Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1285753269

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Registry record

Entity type Organization (Type 2)
Legal business name Port South Village
Other name <Unavail>
Practice address 210 Covil Ave, Wilmington, NC, 28403
Phone (910) 814-1223
Fax (910) 814-1223
Enumeration date Mar 28, 2007
Last updated in NPPES Aug 22, 2020

Taxonomy & classification

310400000X Assisted Living Facility Nursing & Custodial Care Facilities · License HAL- 065-606 (NC) Secondary
310400000X Assisted Living Facility Nursing & Custodial Care Facilities · License HAL-065-005 (NC) Secondary
310400000X Assisted Living Facility Nursing & Custodial Care Facilities · License HAL-065-008 (NC) Primary
310400000X Assisted Living Facility Nursing & Custodial Care Facilities · License HAL-065-009 (NC) Secondary
310400000X Assisted Living Facility Nursing & Custodial Care Facilities · License HAL-065-010 (NC) Secondary
310400000X Assisted Living Facility Nursing & Custodial Care Facilities · License HAL-065-007 (NC) Secondary

Authorized official

Name Buddy Lockamy
Title Administrator
Phone (910) 814-1223

Other identifiers

Identifier Type State Issuer
7801157 Medicaid NC -
7801156 Medicaid NC -
7801395 Medicaid NC -
7801042 Medicaid NC -
7801043 Medicaid NC -
7801041 Medicaid NC -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2020-08-22. Verify at npiregistry.cms.hhs.gov.
Where is Port South Village located?
The practice location on file with NPPES is in Wilmington, NC.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-22.