NPIMap

Organization Active NPI

CMG of North Carolina, Inc.

  • Pediatrics Physician
  • Elizabeth City, NC
National Provider Identifier
1174532972
Registry record updated Aug 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CMG OF NORTH CAROLINA, INC.
Practice address
1735 City Center Blvd
Elizabeth City, NC 27909-8960
Phone
(252) 338-2155
Fax
(252) 338-7704
NPI assigned
Aug 8, 2006
Last updated
Aug 14, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2009

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

Authorized official

Name
Mr. Dennis Michael Ryan
Title
Senior VP/Cfo
Phone
(757) 668-8565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

1735 City Center Blvd
Elizabeth City, NC 27909-8960

Mailing address

601 Childrens LN
Norfolk, VA 23507-1910
Phone (757) 668-7017

National Provider Directory

National Provider Directory

Locations

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250208000000",
    "number": "1174532972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 CHILDRENS LN",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071910",
            "telephone_number": "757-668-7017",
            "fax_number": "757-668-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 CITY CENTER BLVD",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279098960",
            "telephone_number": "252-338-2155",
            "fax_number": "252-338-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMG OF NORTH CAROLINA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2009-08-14",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "SENIOR VP/CFO",
        "authorized_official_telephone_number": "757-668-8565",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.