Croatan Family Medicine, P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

CROATAN FAMILY MEDICINE, P.C.

Practice address

2917 S Croatan Hwy
Nags Head, NC 27959-9027

Phone

(954) 873-7044

NPI assigned

Apr 24, 2024

Last updated

Aug 14, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Needs Demartino Harrison, D.O.NPI 1265929681

Title

President

Phone

(954) 873-7044

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

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.

• Jennifer Needs Demartino Harrison, DO

  • Family Medicine Physician
  • Nags Head, NC
  • NPI 1265929681
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1053167734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1776",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279591776",
            "telephone_number": "252-423-4300",
            "fax_number": "252-862-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2917 S CROATAN HWY",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279599027",
            "telephone_number": "954-873-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROATAN FAMILY MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "NEEDS DEMARTINO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-873-7044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Nags Head, NC
• Providers in Nags Head, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.