Wilmington Medical Group PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

29495 Issued in NC

Legal business name

WILMINGTON MEDICAL GROUP PA

Doing business as

Sneads Ferry Medical

Practice address

1319 NC Highway 210
Sneads Ferry, NC 28460-9144

Phone

(910) 327-2015

Fax

(910) 251-7777

NPI assigned

Jan 29, 2007

Last updated

Nov 20, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James Henry Pridgen, M.D.

Title

Medical Director

Phone

(910) 327-2015

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Sneads Ferry Medical Doing business as

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195516800000",
    "number": "1235275397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925A OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032334",
            "telephone_number": "910-251-8851",
            "fax_number": "910-251-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 NC HIGHWAY 210",
            "city": "SNEADS FERRY",
            "state": "NC",
            "postal_code": "284609144",
            "telephone_number": "910-327-2015",
            "fax_number": "910-251-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMINGTON MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-11-20",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "910-327-2015",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "29495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015V4",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "230038",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "015V4",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sneads Ferry Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wellspring Center PLLC
• Bailee Rhea West
• Amy Christine Whaling, LMSW
• Whitekettle Chiropractic Services, PLLC (Whitekettle Chiropractic)
• Brett E Whitekettle, DC
• Jillian Elizabeth Wisniewski
• Shanice Worsley
• Susan Bell York, L.C.S.W.

• Family Medicine Physician in Sneads Ferry, NC
• Providers in Sneads Ferry, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; 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.