Eastern North Carolina Medical Group, PLLC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

EASTERN NORTH CAROLINA MEDICAL GROUP, PLLC

Practice address

1812 Glendale Dr SW
Suite B
Wilson, NC 27893-4676

Phone

(252) 291-3100

Fax

(252) 243-0599

NPI assigned

Dec 22, 2009

Organization subpart

No

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

Authorized official

Name

Denise H Bailey

Title

Manager

Phone

(252) 451-2700

Specialties & licenses 8

Addresses

Other identifiers 2

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333497600000",
    "number": "1225367253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7867",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040867",
            "telephone_number": "252-451-2700",
            "fax_number": "252-243-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 GLENDALE DR SW",
            "address_2": "SUITE B",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934676",
            "telephone_number": "252-291-3100",
            "fax_number": "252-243-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN NORTH CAROLINA MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-22",
        "last_updated": "2012-04-04",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "252-451-2700"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89011C5",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP ID#",
            "identifier": "011C5",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eastern Carolina Pathology Inc
• Eastern Carolina Pediatrics PA
• Eastern Internal Medicine PA
• Eastern Monitoring Inc
• Eastern NC School for the Deaf
• Eastern North Carolina School for the Deaf
• Eastern Pulmonary & Sleep Medicine
• Kimberly Eatmon
• Beverly Eaton, LCSW
• Ebk Healthcare Services, PLLC

• Pulmonary Disease Physician in Wilson, NC
• Providers in Wilson, NC by specialty
• Pulmonary Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; 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.