NPIMap

Organization Active NPI

East Carolina Health - Chowan Inc

Doing business as Chowan OBGYN

  • Multi-Specialty Clinic/Center
  • Edenton, NC
National Provider Identifier
1336102144
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
200200358 Issued in NC
Legal business name
EAST CAROLINA HEALTH - CHOWAN INC
Doing business as
Chowan OBGYN
Practice address
203 Earnhardt Dr
Edenton, NC 27932-8401
Phone
(252) 482-2134
Fax
(252) 482-5529
NPI assigned
Apr 11, 2006
Last updated
Jul 14, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
EAST CAROLINA HEALTH - CHOWAN INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Authorized official

Name
Mr. Jeffrey N. Sackrison
Title
President
Phone
(252) 482-6268

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 200200358 NC Primary

Addresses

Primary practice location

203 Earnhardt Dr
Edenton, NC 27932-8401

Mailing address

PO Box 569
Edenton, NC 27932-0569
Phone (252) 482-2134

Other identifiers 2

IdentifierTypeStateIssuer
5902688MedicaidNC
018A6OtherNCBCBS PROVIDER #

Other names 1

  • Chowan OBGYN Doing business as

National Provider Directory

National Provider Directory
Part of
Chowan OBGYN

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1336102144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 569",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279320569",
            "telephone_number": "252-482-2134",
            "fax_number": "252-482-5529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 EARNHARDT DR",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279328401",
            "telephone_number": "252-482-2134",
            "fax_number": "252-482-5529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST CAROLINA HEALTH - CHOWAN INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST CAROLINA HEALTH - CHOWAN INC",
        "enumeration_date": "2006-04-11",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "SACKRISON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-482-6268",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NC",
            "license": "200200358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902688",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "018A6",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chowan OBGYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edenton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.