VCG Spring Lake Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

2863 Issued in NC

Legal business name

VCG SPRING LAKE INC

Practice address

810 Chapel Hill Rd
Spring Lake, NC 28390-2140

Phone

(910) 867-5500

Fax

(910) 867-4120

NPI assigned

Jun 2, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Long Saunders

Title

Office Manager

Phone

(910) 867-5500

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1154580587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 CHAPEL HILL RD",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "283902140",
            "telephone_number": "910-867-5500",
            "fax_number": "910-867-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 CHAPEL HILL RD",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "283902140",
            "telephone_number": "910-867-5500",
            "fax_number": "910-867-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VCG SPRING LAKE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "SAUNDERS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LONG",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "910-867-5500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NC",
            "license": "2863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0849Y",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890849Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Spring Lake, NC
• Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.