Obxmd, P.C.

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

2005-01853 Issued in NC

Legal business name

OBXMD, P.C.

Practice address

4721 N Croatan Hwy
Kitty Hawk, NC 27949-8912

Phone

(252) 256-7792

Fax

(252) 256-7691

NPI assigned

Mar 6, 2013

Organization subpart

No

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

Authorized official

Name

Karen A Supan-McPherson, M.D.NPI 1679513790

Title

President

Phone

(252) 256-7792

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Karen A Supan-McPherson, M.D.

  • Emergency Medicine Physician
  • Nags Head, NC
  • NPI 1679513790
  NPD Authorized official
• Jennifer Lynn Jenkins, PA-C

  • Physician Assistant
  • Wilmington, NC
  • NPI 1437393774
  NPD (past)

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362960000000",
    "number": "1134460892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4721 N CROATAN HWY",
            "city": "KITTY HAWK",
            "state": "NC",
            "postal_code": "279498912",
            "telephone_number": "252-256-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4721 N CROATAN HWY",
            "city": "KITTY HAWK",
            "state": "NC",
            "postal_code": "279498912",
            "telephone_number": "252-256-7792",
            "fax_number": "252-256-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBXMD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-06",
        "last_updated": "2013-03-11",
        "status": "A",
        "authorized_official_last_name": "SUPAN-MCPHERSON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-256-7792",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NC",
            "license": "2005-01853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Ann Miller
• Michael B. Morgan, D.D.S.
• Jaclyn Grace Mounie, PT
• Edna Rothman Mullally, DNP, FNP-C
• Obx Optix Optometric, PLLC
• Tammy Sue Odell, MA CCC/SLP
• Outer Banks Physical Therapy, LLC
• Outer Banks Speech and Language PLLC
• Ashley Parham, DMD
• Justin Parker, LCAS-A, LCMHC-A

• All providers in Kitty Hawk, NC
• Urgent Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; 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.