Eastern Neurosurgical and Spine Associates, Inc.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

9300351 Issued in NC

Legal business name

EASTERN NEUROSURGICAL AND SPINE ASSOCIATES, INC.

Practice address

2325 Stantonsburg Rd
Greenville, NC 27834-7534

Phone

(252) 752-5156

Fax

(252) 752-0399

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Carla Dennie McKeithan, RHIT

Title

Credentialing Specialist

Phone

(252) 752-5156

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104989458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347534",
            "telephone_number": "252-752-5156",
            "fax_number": "252-752-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347534",
            "telephone_number": "252-752-5156",
            "fax_number": "252-752-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN NEUROSURGICAL AND SPINE ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCKEITHAN",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "DENNIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "252-752-5156",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RHIT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "9300351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901516",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eastern Laboratory Associates
• Eastern Life Home Health Care.LLC
• Eastern Nephrology Associates ASC LLC
• Eastern Nephrology Associates PLLC
• Eastern Neurosurgical and Spine Associates
• Eastern Oncology & Hematology
• Eastern Pediatrics, P.a.
• Eastern Physical Medicine & Rehabilitation, LLC
• Eastern Podiatry PA
• Eastern Psychiatric & Behavioral Specialists, PLLC

• Physical Medicine & Rehabilitation Physician in Greenville, NC
• Providers in Greenville, NC by specialty
• Physical Medicine & Rehabilitation Physician 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.