NPIMap

Organization Active NPI

Shoreview Medical Associates, PLLC

  • Specialist
  • Carolina Beach, NC
National Provider Identifier
1003879842
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SHOREVIEW MEDICAL ASSOCIATES, PLLC
Practice address
1328 N Lake Park Blvd
Suite 102
Carolina Beach, NC 28428-3945
Phone
(910) 458-8867
Fax
(910) 458-8764
NPI assigned
Apr 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Misty Laine Hall, CPT, CPC
Title
Office Manager
Phone
(910) 458-8867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NC Primary

Addresses

Primary practice location

1328 N Lake Park Blvd
Suite 102
Carolina Beach, NC 28428-3945

Mailing address

PO Box 317
Carolina Beach, NC 28428-0317
Phone (910) 458-8867

Other identifiers 2

IdentifierTypeStateIssuer
016AFOtherNCBLUE CROSS AND BLUE SHIEL
89016AFMedicaidNC

National Provider Directory

National Provider Directory

Locations

141 N Main St
Fuquay Varina, NC 27526
Phone (919) 577-6807

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003879842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 317",
            "city": "CAROLINA BEACH",
            "state": "NC",
            "postal_code": "284280317",
            "telephone_number": "910-458-8867",
            "fax_number": "910-458-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 N LAKE PARK BLVD",
            "address_2": "SUITE 102",
            "city": "CAROLINA BEACH",
            "state": "NC",
            "postal_code": "284283945",
            "telephone_number": "910-458-8867",
            "fax_number": "910-458-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOREVIEW MEDICAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "LAINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "910-458-8867",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPT, CPC"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "016AF",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89016AF",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina Beach, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.