Individual provider Active NPI

Emmanuel Estranero Eugenio, M.D.

  • Pediatrics Physician
  • Whiteville, NC
National Provider Identifier
1174551733
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2025-01504 Issued in NC
Practice address
36 McNeill PLZ
Whiteville, NC 28472-8602
Phone
(910) 640-4064
NPI assigned
Jun 30, 2006
Last updated
Jul 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2025-01504 NC Primary

Addresses

Primary practice location

36 McNeill PLZ
Whiteville, NC 28472-8602

Mailing address

36 McNeill PLZ
Whiteville, NC 28472-8602
Phone (910) 640-4064

Other identifiers 10

IdentifierTypeStateIssuer
223542OtherVAANTHEM BCBS OF VA
4944612OtherVACIGNA
5488498OtherVAAETNA HMO
006710018MedicaidVA
270500OtherVASOUTHERN HEALTH SERVICES
C06193OtherVAGROUP PTAN
45912OtherVASENTARA
5488498OtherVAAETNA LIFE
854726OtherVAMAMSI
1174551733MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110506000475 VA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 3173708138 Reassigns benefits to 1 organization
I20250918002043 NC Practitioner - Pediatric Medicine 3173708138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4435 Golf Acres Dr
Charlotte, NC 28208-5947

PO Box
Suite 19305
Charlotte, NC 28219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2025-01504NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Regional Health Network Current Accepting new patients
Childrens Hospital of the Kings Daughters Inc CurrentSince Jan 1, 2016 Accepting new patients
Columbus Regional Health Network CurrentSince Aug 18, 2025 Accepting new patients
Columbus Regional Health Network Pediatrics CurrentSince Aug 18, 2025 Accepting new patients
Bon Secours - Memorial Regional Medical Center, Inc. Past Accepting new patients
Columbus Regional Health Network Past Accepting new patients

Locations

36 McNeill Plz
Whiteville, NC 28472
Phone (910) 640-4064

612 Jefferson St
#28
Whiteville, NC 28472
Phone (910) 640-4064

817 Volvo Pkwy
Chesapeake, VA 23320
Phone (757) 668-4630

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1174551733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 MCNEILL PLZ",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284728602",
            "telephone_number": "910-640-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 MCNEILL PLZ",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284728602",
            "telephone_number": "910-640-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUGENIO",
        "first_name": "EMMANUEL",
        "middle_name": "ESTRANERO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2025-01504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS OF VA",
            "identifier": "223542",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4944612",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "5488498",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006710018",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH SERVICES",
            "identifier": "270500",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06193",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA",
            "identifier": "45912",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA LIFE",
            "identifier": "5488498",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "854726",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174551733",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

Verify at the official NPI Registry.