Organization Active NPI

Pitt Children's Clinic, PA

  • Pediatrics Physician
  • Greenville, NC
National Provider Identifier
1356453476
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20383 Issued in NC
Legal business name
PITT CHILDREN'S CLINIC, PA
Practice address
1800 W 5TH St
Suite 8
Greenville, NC 27834-2888
Phone
(252) 758-1750
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. George Edward Davis, MD
Title
Owner
Phone
(252) 758-1750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 20383 NC Primary

Addresses

Primary practice location

1800 W 5TH St
Suite 8
Greenville, NC 27834-2888

Mailing address

1800 W 5TH St
Suite 8
Greenville, NC 27834-2888
Phone (252) 758-1750

Other identifiers 2

IdentifierTypeStateIssuer
02448OtherNCNORTH CAROLINA BC/BS
8902448MedicaidNC

National Provider Directory

National Provider Directory

Locations

1800 W 5th St
Ste 8
Greenville, NC 27834
Phone (252) 758-1750

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356453476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W 5TH ST",
            "address_2": "SUITE 8",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342888",
            "telephone_number": "252-758-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W 5TH ST",
            "address_2": "SUITE 8",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342888",
            "telephone_number": "252-758-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PITT CHILDREN'S CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-758-1750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "20383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA BC/BS",
            "identifier": "02448",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902448",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.