NPIMap

Organization Active NPI

Carolina Regional Orthopaedics, PA

Doing business as Carolina Regional Orthopaedics

  • Orthopaedic Surgery Physician
  • Tarboro, NC
National Provider Identifier
1073553509
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
CAROLINA REGIONAL ORTHOPAEDICS, PA
Doing business as
Carolina Regional Orthopaedics
Practice address
2906 N Main St
Tarboro, NC 27886-1921
Phone
(252) 823-7212
Fax
(252) 823-5668
NPI assigned
Jun 6, 2006
Last updated
May 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Authorized official

Name
Ms. Allison Brake
Title
Office Supervisor
Phone
(252) 823-7212

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

2906 N Main St
Tarboro, NC 27886-1921

Mailing address

2906 N Main St
Tarboro, NC 27886-1921
Phone (252) 823-7212

Other identifiers 3

IdentifierTypeStateIssuer
890174KMedicaidNC
CK0207OtherRAILROAD MEDICARE
0174KOtherBCBS

Other names 1

  • Carolina Regional Orthopaedics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040924000475 NC Part B Supplier - Clinic/Group Practice 2062480239 Receives reassigned benefits from 18 practitioners
1 other NPI on this enrollment
Practice locations: Rocky Mount, NC; Tarboro, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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

Locations

2906 N Main St
Tarboro, NC 27886
Phone (252) 443-0400

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6545/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651449600000",
    "number": "1073553509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2906 N MAIN ST",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278861921",
            "telephone_number": "252-823-7212",
            "fax_number": "252-823-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 N MAIN ST",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278861921",
            "telephone_number": "252-823-7212",
            "fax_number": "252-823-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA REGIONAL ORTHOPAEDICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "BRAKE",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "OFFICE SUPERVISOR",
        "authorized_official_telephone_number": "252-823-7212",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890174K",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK0207",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0174K",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Regional Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carolina Regional Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tarboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.