NPIMap

Organization Active NPI

Pungo District Hospital Corporation

  • Cognitive & Behavioral Psychologist
  • Belhaven, NC
National Provider Identifier
1073634192
Registry record updated Oct 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
H0002 Issued in NC
Legal business name
PUNGO DISTRICT HOSPITAL CORPORATION
Practice address
202 E Water St
Belhaven, NC 27810-1450
Phone
(252) 943-2111
Fax
(252) 944-2236
NPI assigned
Apr 3, 2007
Last updated
Oct 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2011

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

Authorized official

Name
Mr. Harvey Case
Title
President
Phone
(252) 944-2208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X H0002 NC Primary

Addresses

Primary practice location

202 E Water St
Belhaven, NC 27810-1450

Mailing address

202 E Water St
Belhaven, NC 27810-1450
Phone (252) 943-2111

Other identifiers 1

IdentifierTypeStateIssuer
6005717MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Pungo District Hospital Corporation5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319760000000",
    "number": "1073634192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E WATER ST",
            "city": "BELHAVEN",
            "state": "NC",
            "postal_code": "278101450",
            "telephone_number": "252-943-2111",
            "fax_number": "252-944-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E WATER ST",
            "city": "BELHAVEN",
            "state": "NC",
            "postal_code": "278101450",
            "telephone_number": "252-943-2111",
            "fax_number": "252-944-2236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUNGO DISTRICT HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2011-10-28",
        "status": "A",
        "authorized_official_last_name": "CASE",
        "authorized_official_first_name": "HARVEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-944-2208",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NC",
            "license": "H0002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005717",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belhaven, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; 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.