Bladen Medical Associates

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

200993 Issued in NC

Legal business name

BLADEN MEDICAL ASSOCIATES

Practice address

106TH 4TH Street
Bladenboro, NC 28320

Phone

(910) 863-3138

Fax

(910) 863-3597

NPI assigned

Apr 3, 2007

Last updated

Aug 7, 2008By 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

Mrs. Donna L Bowen

Title

Administrative Assistant

Phone

(910) 862-5507

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Bladen Healthcare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bladen Medical Associates

  • Nurse Practitioner
  • Dublin, NC
  • NPI 1205957214
  NPD tax ID

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1316068307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "BLADENBORO",
            "state": "NC",
            "postal_code": "28320",
            "telephone_number": "910-863-3138",
            "fax_number": "910-863-3597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106TH 4TH STREET",
            "city": "BLADENBORO",
            "state": "NC",
            "postal_code": "28320",
            "telephone_number": "910-863-3138",
            "fax_number": "910-863-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLADEN MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "BOWEN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "910-862-5507",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "200993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344601A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344601C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• A&N FCH Two
• Iesha Shonta Bell
• Jazlyn Best
• Bladen Healthcare LLC (Cape Fear Valley Bladenboro Pharmacy)
• Bladen Healthcare, LLC (Cape Fear Valley BMA Bladenboro)
• Bladenboro Rescue Squad
• Jacquelyn Anne Boyce
• Candice Jones Bryan, FNP
• Bse, Inc (The Medicine Shoppe)
• Bse, Inc. (The Medicine Shoppe 0230)

• Nurse Practitioner in Bladenboro, NC
• Providers in Bladenboro, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; 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.