Beachcare Urgent Medical Care Center of Havelock

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

39759 Issued in NC

Legal business name

BEACHCARE URGENT MEDICAL CARE CENTER OF HAVELOCK

Doing business as

Beachcare of Havelock

Practice address

1224 E Main St
Havelock, NC 28532-2405

Phone

(252) 447-7474

Fax

(252) 447-1050

NPI assigned

Sep 27, 2005

Last updated

Nov 4, 2010By 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

Mr. William Graham Evans Jr., PA-CNPI 1952397101

Title

Clinical Director/Owner

Phone

(252) 447-7474

Specialties & licenses 1

Addresses

Other names 1

• Beachcare of Havelock Doing business as

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.

• William Graham Evans Jr., PAC

  • Medical Physician Assistant
  • Havelock, NC
  • NPI 1952397101
  NPD (past) Authorized official

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1083600720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 E MAIN ST",
            "city": "HAVELOCK",
            "state": "NC",
            "postal_code": "285322405",
            "telephone_number": "252-447-7474",
            "fax_number": "252-447-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 E MAIN ST",
            "city": "HAVELOCK",
            "state": "NC",
            "postal_code": "285322405",
            "telephone_number": "252-447-7474",
            "fax_number": "252-447-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHCARE URGENT MEDICAL CARE CENTER OF HAVELOCK",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "GRAHAM",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "252-447-7474",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NC",
            "license": "39759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beachcare of Havelock",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Rural Health Clinic/Center in Havelock, NC
• Providers in Havelock, NC by specialty
• Rural Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; 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.