Halifax Gastroenterology PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

9700163 Issued in NC

Legal business name

HALIFAX GASTROENTEROLOGY PC

Practice address

1007 Gregory Dr
Roanoke Rapids, NC 27870-6451

Phone

(252) 535-6478

Fax

(252) 535-6483

NPI assigned

Aug 5, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Padma Devi Yerra

Title

Off Manager

Phone

(252) 535-6478

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC2 enrollments

Enrollment records 2

Listed as

Halifax Gastroenterology PCCCN 34C0001186

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nagarjuna Yerra, MD

  • Gastroenterology Physician
  • Roanoke Rapids, NC
  • NPI 1275542649
  Medicare reassignment NPD

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1306855770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 GREGORY DR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278706451",
            "telephone_number": "252-535-6478",
            "fax_number": "252-535-6483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 GREGORY DR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278706451",
            "telephone_number": "252-535-6478",
            "fax_number": "252-535-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALIFAX GASTROENTEROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "YERRA",
        "authorized_official_first_name": "PADMA",
        "authorized_official_middle_name": "DEVI",
        "authorized_official_title_or_position": "OFF MANAGER",
        "authorized_official_telephone_number": "252-535-6478",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "9700163",
            "primary": true
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NC",
            "license": "AS0141",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0167J",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891068E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kamlesh Gupta, M.D.
• Patrick Guy
• Halifax Anesthesia and Pain Clinic, Inc.
• Halifax Anesthesia and Pain Clinic, PC
• Halifax Eye Center PA
• Halifax Medical Specialists PA
• Halifax Northampton Internal Medicine, PA
• Halifax Orthopaedic & Hand Surgery Clinic PA
• Halifax Pediatrics, P.a.
• Halifax Psychiatry

• Gastroenterology Physician in Roanoke Rapids, NC
• Providers in Roanoke Rapids, NC by specialty
• Gastroenterology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.