Town of Pine Knoll Shores

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1243 Issued in NC

Legal business name

TOWN OF PINE KNOLL SHORES

Practice address

314 Salter Path Rd.
Pine Knoll Shores, NC 28512

Phone

(252) 247-2268

Fax

(252) 247-2897

NPI assigned

Jun 4, 2006

Organization subpart

No

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

Authorized official

Name

Julie Anderson

Title

Asst. Town Manager

Phone

(252) 247-4353

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463356800000",
    "number": "1144268772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 193",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296410193",
            "telephone_number": "866-981-5886",
            "fax_number": "866-981-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 SALTER PATH RD.",
            "city": "PINE KNOLL SHORES",
            "state": "NC",
            "postal_code": "28512",
            "telephone_number": "252-247-2268",
            "fax_number": "252-247-2897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF PINE KNOLL SHORES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2016-05-16",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "ASST. TOWN MANAGER",
        "authorized_official_telephone_number": "252-247-4353"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NC",
            "license": "1243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406728",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Hunter Chadwick III, MS, LCAS, LCMHC-S
• Graham'S Dermatology Services, PA
• Kevin M. McKnight, MD
• Russell Meyers, LCAS-A
• Margaret Flaherty Prevost, LPC, LCMHC

• Land Ambulance in Pine Knoll Shores, NC
• Providers in Pine Knoll Shores, NC by specialty
• Land Ambulance in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.