NPIMap

Organization Active NPI

Charles Otis Boyette MD

Doing business as CO Boyette Medical Clinic

  • Family Medicine Physician
  • Belhaven, NC
National Provider Identifier
1083671135
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CHARLES OTIS BOYETTE MD
Doing business as
CO Boyette Medical Clinic
Practice address
216 Haslin Street
Belhaven, NC 27810
Phone
(252) 943-6144
Fax
(252) 943-2038
NPI assigned
May 1, 2006
Last updated
Mar 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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

Authorized official

Name
Mr. Charles Otis Boyette Sr., MD
Title
Owner
Phone
(252) 943-6144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

216 Haslin Street
Belhaven, NC 27810

Mailing address

PO Box 310
Belhaven, NC 27810-0310
Phone (252) 943-6144

Other identifiers 1

IdentifierTypeStateIssuer
890201WMedicaidNC

Other names 1

  • CO Boyette Medical Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269302400000",
    "number": "1083671135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 310",
            "city": "BELHAVEN",
            "state": "NC",
            "postal_code": "278100310",
            "telephone_number": "252-943-6144",
            "fax_number": "252-943-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 HASLIN STREET",
            "city": "BELHAVEN",
            "state": "NC",
            "postal_code": "27810",
            "telephone_number": "252-943-6144",
            "fax_number": "252-943-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES OTIS BOYETTE MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2010-03-23",
        "status": "A",
        "authorized_official_last_name": "BOYETTE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "OTIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-943-6144",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890201W",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CO Boyette Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 23, 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.