Carolina Pines Medical, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200301290 Issued in NC

Legal business name

CAROLINA PINES MEDICAL, PC

Practice address

3215 Henderson Dr
Jacksonville, NC 28546-5251

Phone

(910) 347-5444

NPI assigned

Dec 1, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Michael Patrick Shusko, M.D.

Title

President

Phone

(910) 347-5444

Specialties & licenses 2

Addresses

Other names 1

• Carolina Pines Wellness Center Doing business as

Locations

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234224000000",
    "number": "1164677332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 HENDERSON DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465251",
            "telephone_number": "910-347-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 HENDERSON DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465251",
            "telephone_number": "910-347-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA PINES MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2009-02-10",
        "status": "A",
        "authorized_official_last_name": "SHUSKO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-347-5444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200301290",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NC",
            "license": "200301290",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Pines Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carolina Coast Lactation, LLC
• Carolina Healthcare Associates Inc
• Carolina Home Medical, Inc.
• Carolina Homecare Group, LLC
• Carolina Orthopedic and Sports Medicine, Inc.
• Carolina Psychological and Psychiatric Health SRVS, PA
• Carolina Residential Services, Inc
• Carolina Women'S Health Pavilion, PA
• Carolinaeast Physicians
• Carolinaeast Physicians

• Family Medicine Physician in Jacksonville, NC
• Providers in Jacksonville, 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 Feb 10, 2009; 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.