NPIMap

Organization Active NPI

Beaufort County Hospital Association Inc

Doing business as Tideland Psychiatric Services Plymouth

  • Psychiatry Physician
  • Plymouth, NC
National Provider Identifier
1083842264
Registry record updated Jun 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BEAUFORT COUNTY HOSPITAL ASSOCIATION INC
Doing business as
Tideland Psychiatric Services Plymouth
Practice address
804 Washington St
Plymouth, NC 27962-2224
Phone
(252) 793-1154
Fax
(252) 793-3860
NPI assigned
Jun 26, 2009
Last updated
Jun 26, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2009

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

Authorized official

Name
Susan S Gerard
Title
Medical Practice Administrator
Phone
(252) 975-4203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

804 Washington St
Plymouth, NC 27962-2224

Mailing address

804 Washington St
Plymouth, NC 27962-2224
Phone (252) 793-1154

Other names 1

  • TIDELAND PSYCHIATRIC SERVICES PLYMOUTH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beaufort County Hospital Association Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

804 Washington St
Plymouth, NC 27962
Phone (252) 793-1154

NPI Registry JSON

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245974400000",
    "number": "1083842264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 WASHINGTON ST",
            "city": "PLYMOUTH",
            "state": "NC",
            "postal_code": "279622224",
            "telephone_number": "252-793-1154",
            "fax_number": "252-793-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 WASHINGTON ST",
            "city": "PLYMOUTH",
            "state": "NC",
            "postal_code": "279622224",
            "telephone_number": "252-793-1154",
            "fax_number": "252-793-3860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUFORT COUNTY HOSPITAL ASSOCIATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-26",
        "last_updated": "2009-06-26",
        "status": "A",
        "authorized_official_last_name": "GERARD",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "252-975-4203"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TIDELAND PSYCHIATRIC SERVICES PLYMOUTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plymouth, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.