NPIMap

Organization Active NPI

Eastern Medical Associates, PA

  • General Practice Physician
  • Goldsboro, NC
National Provider Identifier
1194762807
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
EASTERN MEDICAL ASSOCIATES, PA
Practice address
2609 Medical Office PL
Goldsboro, NC 27534-9428
Phone
(919) 734-1779
Fax
(919) 734-7570
NPI assigned
Jun 1, 2006
Last updated
Jan 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Authorized official

Name
Mr. Philip Douglas Mayo, M.D.NPI 1275572208
Title
President
Phone
(919) 734-1779

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

2609 Medical Office PL
Goldsboro, NC 27534-9428

Mailing address

2609 Medical Office PL
Goldsboro, NC 27534-9428
Phone (919) 734-1779

Other identifiers 2

IdentifierTypeStateIssuer
890112RMedicaidNC
CI3418OtherNCMEDICARE RAILROAD

National Provider Directory

National Provider Directory

Locations

5413 US Highway 117 N
Pikeville, NC 27863
Phone (919) 242-5271

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389052800000",
    "number": "1194762807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 MEDICAL OFFICE PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349428",
            "telephone_number": "919-734-1779",
            "fax_number": "919-734-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 MEDICAL OFFICE PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349428",
            "telephone_number": "919-734-1779",
            "fax_number": "919-734-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN MEDICAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2014-01-07",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-734-1779",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890112R",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CI3418",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; 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.