Eastern Carolina Internal Medicine PA

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

REGISTRATIONNO39206 Issued in NC

Legal business name

EASTERN CAROLINA INTERNAL MEDICINE PA

Practice address

2117 South Glenburnie Road
Ste 9 & 10
New Bern, NC 28562-2239

Phone

(252) 636-1001

Fax

(252) 636-1188

NPI assigned

Dec 11, 2006

Organization subpart

No

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

Authorized official

Name

Craig A Holton

Title

Chief Operating Officer

Phone

(252) 633-1010

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093875239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 SOUTH GLENBURNIE ROAD",
            "address_2": "STE 9 & 10",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622239",
            "telephone_number": "252-636-1001",
            "fax_number": "252-636-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 SOUTH GLENBURNIE ROAD",
            "address_2": "STE 9 & 10",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622239",
            "telephone_number": "252-636-1001",
            "fax_number": "252-636-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN CAROLINA INTERNAL MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLTON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "252-633-1010"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NC",
            "license": "REGISTRATIONNO39206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "01907",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7902320",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Easter Seals Ucp North Carolina & Virginia, Inc.
• Easter Seals Ucp North Carolina and Virginia
• Easter Seals Ucp North Carolina, Inc.
• Eastern Carolina Glaucoma and Vision Center
• Eastern Carolina Health Resources
• Eastern Carolina Internal Medicine PA
• Eastern Carolina Internal Medicine PA
• Eastern Carolina Internal Medicine PA
• Eastern Carolina Wellness Group
• Eastern Carolina Women'S Center, PA

• Multi-Specialty Clinic/Center in New Bern, NC
• Providers in New Bern, NC by specialty
• Multi-Specialty Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.