NPIMap

Organization Active NPI

Eastern Carolina Pediatrics PA

  • Pediatrics Physician
  • Wilson, NC
National Provider Identifier
1073693347
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
EASTERN CAROLINA PEDIATRICS PA
Doing business as
Eastern Carolina Pediatrics PA
Practice address
1702 Medical Park Dr W
Wilson, NC 27893-2705
Phone
(252) 243-7944
Fax
(252) 243-6097
NPI assigned
Oct 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Linda M Davis
Title
Office Manager
Phone
(252) 243-7944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

1702 Medical Park Dr W
Wilson, NC 27893-2705

Mailing address

1702 Medical Park Dr W
Wilson, NC 27893-2705
Phone (252) 243-7944

Other identifiers 1

IdentifierTypeStateIssuer
890120EMedicaidNC

Other names 1

  • EASTERN CAROLINA PEDIATRICS PA Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0242389Eastern Carolina Pediatrics1702 Medical Park Drive, Wilson, NC 27893AccreditationNov 10, 2026

National Provider Directory

National Provider Directory

Locations

1702 Medical Park Dr W
Wilson, NC 27893
Phone (252) 243-7944

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073693347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 MEDICAL PARK DR W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278932705",
            "telephone_number": "252-243-7944",
            "fax_number": "252-243-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 MEDICAL PARK DR W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278932705",
            "telephone_number": "252-243-7944",
            "fax_number": "252-243-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN CAROLINA PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "252-243-7944"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890120E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EASTERN CAROLINA PEDIATRICS PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilson, 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.