Sentara Albemarle Regional Medical Center, LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

SENTARA ALBEMARLE REGIONAL MEDICAL CENTER, LLC

Practice address

5200 N Croatan Hwy
Kitty Hawk, NC 27949-3990

Phone

(252) 255-6020

NPI assigned

Jun 19, 2014

Organization subpart

Yes

Parent organization

SENTARA HOSPITALSAs reported in NPPES

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

Authorized official

Name

Mr. Robert A Broermann

Title

Sr VP/Cfo

Phone

(757) 455-7020

Specialties & licenses 2

Addresses

Other names 1

• Sentara Kitty Hawk Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Sentara Albemarle Regional Medical Center

  • General Acute Care Hospital
  • Elizabeth City, NC
  • NPI 1154708436

  O20140630001120

  Same enrollment
• Sentara Albemarle Regional Medical Center, LLC

  • Certified Registered Nurse Anesthetist
  • Kitty Hawk, NC
  • NPI 1477967248

  O20140630001120

  Same enrollment

Part of

Sentara Hospitals Dba BGRP

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1194139964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 N CROATAN HWY",
            "city": "KITTY HAWK",
            "state": "NC",
            "postal_code": "279493990",
            "telephone_number": "252-255-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 N CROATAN HWY",
            "city": "KITTY HAWK",
            "state": "NC",
            "postal_code": "279493990",
            "telephone_number": "252-255-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENTARA ALBEMARLE REGIONAL MEDICAL CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SENTARA HOSPITALS",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "BROERMANN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SR VP/CFO",
        "authorized_official_telephone_number": "757-455-7020",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sentara Kitty Hawk",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Regional Medical Services Inc
• Sandra Dunn Reid, LPC
• Eric Robisch, PA-C
• Seaside Physical Therapy LLC
• Sentara Albemarle Regional Medical Center LLC
• Sentara Albemarle Regional Medical Center, LLC
• Sentara Albemarle Regional Medical Center, LLC
• Sentara Albemarle Regional Medical Center, LLC
• Sentara Medical Group
• Rebecca Ann Shealey, M.S. CCC-SLP

• All providers in Kitty Hawk, NC
• Anesthesiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; 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.