NPIMap

Organization Active NPI

Easter Seals Ucp North Carolina & Virginia, Inc.

  • Pharmacy
  • New Bern, NC
National Provider Identifier
1013769629
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Practice address
1309 Tatum Dr
New Bern, NC 28560-4314
Phone
(252) 672-2141
NPI assigned
Apr 5, 2024
Last updated
Apr 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Authorized official

Name
Brett Turner Beavers
Title
Credentialing Manager
Phone
(919) 210-7661

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

1309 Tatum Dr
New Bern, NC 28560-4314

Mailing address

5171 Glenwood Ave Ste 211
Raleigh, NC 27612-3266
Phone (919) 783-8898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260115000407 NC Part B Supplier - Pharmacy 7618161407 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, NC; New Bern, NC

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Easterseals Ucp North Carolina Virginia224 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

624 S Fayetteville St
Ste D
Asheboro, NC 27203
Phone (336) 318-2953

2505 S Mebane St
Ste A
Burlington, NC 27215
Phone (336) 222-0291

2505 S Mebane St
Ste B
Burlington, NC 27215
Phone (336) 223-0444

3305 16th Ave SE
Ste 205
Conover, NC 28613

3608 University Dr
Ste 101
Durham, NC 27707
Phone (919) 433-0170

433 W Main St
Durham, NC 27701
Phone (919) 433-0170

116 N Cool Spring St
Fayetteville, NC 28301
Phone (910) 500-6606

1101 Greenville Blvd SE
Greenville, NC 27858
Phone (252) 756-6533

600 Lynndale Ct
Ste D
Greenville, NC 27858
Phone (252) 353-8001

110 Branchwood Dr
Ste B
Jacksonville, NC 28546
Phone (910) 650-6926

824 Gum Branch Rd
Ste C
Jacksonville, NC 28540
Phone (910) 218-0006

824 Gum Branch Rd
Ste D
Jacksonville, NC 28540

2808 S Croatan Hwy
Ste B
Nags Head, NC 27959
Phone (252) 441-2324

6026 Six Forks Rd
Raleigh, NC 27609
Phone (919) 865-8710

427 S Hancock St
Rockingham, NC 28379
Phone (910) 997-2676

154 Beacon Dr
Ste 1
Winterville, NC 28590
Phone (252) 353-8001

Practitioners & affiliated clinicians

Practitioners 123

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 123

NPI Registry JSON

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

{
    "created_epoch": "1712275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712275200000",
    "number": "1013769629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 GLENWOOD AVE STE 211",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123266",
            "telephone_number": "919-783-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 TATUM DR",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285604314",
            "telephone_number": "252-672-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-05",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A",
        "authorized_official_last_name": "BEAVERS",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "TURNER",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "919-210-7661"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.