NPIMap

Organization Active NPI

Crystal River Psychiatric, GRP

  • Psychiatry Physician
  • Wilmington, NC
National Provider Identifier
1003946047
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
104694 Issued in NC
Legal business name
CRYSTAL RIVER PSYCHIATRIC, GRP
Practice address
2595 S 17TH St
Wilmington, NC 28401-7748
Phone
(910) 799-2283
Fax
(910) 791-9227
NPI assigned
Mar 7, 2007
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
Robert Harvey Weinstein, M.D.
Title
Owner
Phone
(910) 799-2283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 104694 NC Primary

Addresses

Primary practice location

2595 S 17TH St
Wilmington, NC 28401-7748

Mailing address

2595 S 17TH St
Wilmington, NC 28401-7748
Phone (910) 799-2283

Other identifiers 5

IdentifierTypeStateIssuer
8986321OtherNCWEINSTEINS MEDICAID
014J9OtherNCBCBS NC GROUP #
6107129OtherNCF.RHETT SARAVIA MEDICAID
86321OtherNCWEINSTEINS BCBS NC
201516COtherNCWEINSTEINS MEDICARE PIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003946047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017748",
            "telephone_number": "910-799-2283",
            "fax_number": "910-791-9227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2595 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017748",
            "telephone_number": "910-799-2283",
            "fax_number": "910-791-9227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL RIVER PSYCHIATRIC, GRP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEINSTEIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "HARVEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-799-2283",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "104694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WEINSTEINS MEDICAID",
            "identifier": "8986321",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC GROUP #",
            "identifier": "014J9",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "F.RHETT SARAVIA MEDICAID",
            "identifier": "6107129",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WEINSTEINS BCBS NC",
            "identifier": "86321",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WEINSTEINS MEDICARE PIN",
            "identifier": "201516C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, 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.