Wilmington Medical Group PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WILMINGTON MEDICAL GROUP PA

Doing business as

Intramed

Practice address

602 Thomasboro Rd
Calabash, NC 28467-2155

Phone

(910) 579-1872

Fax

(910) 251-7777

NPI assigned

Jan 30, 2007

Last updated

Nov 20, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James Henry Pridgen, M.D.

Title

Medical Director

Phone

(910) 579-1872

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Intramed Doing business as

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195516800000",
    "number": "1124164637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925A OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032334",
            "telephone_number": "910-251-8851",
            "fax_number": "910-251-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 THOMASBORO RD",
            "city": "CALABASH",
            "state": "NC",
            "postal_code": "284672155",
            "telephone_number": "910-579-1872",
            "fax_number": "910-251-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMINGTON MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-11-20",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "910-579-1872",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "230038",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "017CR",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901139",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intramed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wal-Mart Stores East LP (Walmart Vision Center 30-4269)
• Wal-Mart Stores East, LP (Walmart Pharmacy 10-4269)
• Kathy Hinman Walker, PHYSICIAN ASST
• Brandon Thomas Whittington, DPT
• Sharon Rising Wilkerson, FNP-C
• Nathaniel Winstead
• Teresa Wright, FNP-C

• Family Medicine Physician in Calabash, NC
• Providers in Calabash, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; 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.