NPIMap

Organization Active NPI

Atlantic Urology PC

  • Urology Physician
  • Southport, NC
National Provider Identifier
1073770939
Registry record updated Mar 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ATLANTIC UROLOGY PC
Practice address
4222 Long Beach Rd SE
Southport, NC 28461-8627
Phone
(910) 362-8765
NPI assigned
May 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2009

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

Authorized official

Name
Richard J Mynatt, MD
Title
President
Phone
(910) 362-8765

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

4222 Long Beach Rd SE
Southport, NC 28461-8627

Mailing address

PO Box 600085
Raleigh, NC 27675-6085
Phone (910) 362-8765

National Provider Directory

National Provider Directory
Tax ID family
Atlantic Urology PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235952000000",
    "number": "1073770939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600085",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276756085",
            "telephone_number": "910-362-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4222 LONG BEACH RD SE",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284618627",
            "telephone_number": "910-362-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC UROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2009-03-02",
        "status": "A",
        "authorized_official_last_name": "MYNATT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-362-8765",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; 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.