Prestige Cardiopulmonary Diagnostic Services, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

9558523 Issued in NC

Legal business name

PRESTIGE CARDIOPULMONARY DIAGNOSTIC SERVICES, LLC

Practice address

508 E Main St Ste 209
Elizabeth City, NC 27909-4458

Phone

(252) 621-1052

NPI assigned

Nov 18, 2013

Organization subpart

No

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

Authorized official

Name

David A Newcomer, RRT

Title

Owner

Phone

(252) 621-1052

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384732800000",
    "number": "1134559800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 E MAIN ST STE 209",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279094458",
            "telephone_number": "252-621-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 E MAIN ST STE 209",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279094458",
            "telephone_number": "252-621-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE CARDIOPULMONARY DIAGNOSTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-18",
        "last_updated": "2013-11-18",
        "status": "A",
        "authorized_official_last_name": "NEWCOMER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-621-1052",
        "authorized_official_credential": "RRT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NC",
            "license": "9558523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlene L Powell, SAP, LCAS, CADC,
• Robert N Powell, M.D.
• Casey Powles, DPT
• Carla Francisna Poyner
• Praxair Healthcare Services, Inc.
• Othella M Price, LMT
• Pride in North Carolina, Inc.
• Pride in North Carolina, LLC
• Princeton Behavioral Health
• Princeton Behavioral Health, Inc.

• Clinic/Center in Elizabeth City, NC
• Providers in Elizabeth City, NC by specialty
• Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.