Our Children'S Clinic, PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

OUR CHILDREN'S CLINIC, PA

Practice address

4024A Old Tar Rd
Winterville, NC 28590-8430

Phone

(252) 355-3773

Fax

(252) 355-1958

NPI assigned

Aug 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Angela G. Stewart, MDNPI 1508894551

Title

President

Phone

(252) 355-3773

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Angela Stewart, MD

  • Pediatrics Physician
  • Winterville, NC
  • NPI 1508894551
  NPD (past) Authorized official
• Macy Becker, FNP

  • Family Nurse Practitioner
  • Winterville, NC
  • NPI 1700765948
  NPD (past)
• Louise Bradshaw, MD

  • Pediatrics Physician
  • Winterville, NC
  • NPI 1831127877
  NPD (past)
• Joseph P Byrne, PAC

  • Medical Physician Assistant
  • Winterville, NC
  • NPI 1003034745
  NPD (past)
• Marybeth Christine Rudy, PA

  • Physician Assistant
  • Hershey, PA
  • NPI 1528524782
  NPD (past)

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124135603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4024A OLD TAR RD",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285908430",
            "telephone_number": "252-355-3773",
            "fax_number": "252-355-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024A OLD TAR RD",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285908430",
            "telephone_number": "252-355-3773",
            "fax_number": "252-355-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR CHILDREN'S CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-355-3773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "0264E",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890264E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Winterville, NC
• Providers in Winterville, NC by specialty
• Pediatrics 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.