Individual provider Active NPI

Ashraf GB Mikhail, MD

  • Psychiatry Physician
  • Jacksonville, NC
National Provider Identifier
1083690515
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
200200418 Issued in NC
Practice address
200 Tarpon Trail
Jacksonville, NC 28546-5266
Phone
(910) 938-1114
Fax
(910) 938-1118
NPI assigned
Dec 16, 2005
Last updated
Apr 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 200200418 NC Primary

Addresses

Primary practice location

200 Tarpon Trail
Jacksonville, NC 28546-5266

Mailing address

200 Tarpon Trail
Jacksonville, NC 28546-5266
Phone (910) 938-1114

Other identifiers 1

IdentifierTypeStateIssuer
891335UMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040412000817 NC Practitioner - Psychiatry 0749274967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Carolina Neuropsychiatric Center PAGroup PAC ID 5890794689, 28 clinicians

Practice addresses (Care Compare)

1630 Military Cutoff Rd
Suite 108
Wilmington, NC 28403-5719
Phone (910) 938-1114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200200418NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Carolina Neuropsychiatric Center, PA Psychiatry CurrentSince Oct 1, 2006 Accepting new patients
Jacksonville Children's and Multispecialty Clinic, PA PastSince Nov 27, 2011 Accepting new patients
Family Care Clinic, P.a. Past Accepting new patients
Carolina Psychological and Psychiatric Health SRVS, PA Psychiatry PastSince Nov 1, 1999 Accepting new patients
Coastal Carolina Neuropsychiatric Center, PA Psychiatry Past Accepting new patients
Mary Washington Healthcare Specialty Services LLC Past Accepting new patients
Resolutions Counseling and Mediation Services, PLLC Past Accepting new patients

Locations

200 Tarpon Trl
Jacksonville, NC 28546
Phone 9109381114139

1630 Military Cutoff Rd
Ste 108
Wilmington, NC 28403

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1083690515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TARPON TRAIL",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465266",
            "telephone_number": "910-938-1114",
            "fax_number": "910-938-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TARPON TRAIL",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465266",
            "telephone_number": "910-938-1114",
            "fax_number": "910-938-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKHAIL",
        "first_name": "ASHRAF",
        "middle_name": "GB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "200200418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891335U",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.