County of Brunswick

Primary specialty

State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X

Legal business name

COUNTY OF BRUNSWICK

Doing business as

Brunswick County Employee Clinic

Practice address

75 Stamp Act Dr
Bolivia, NC 28422-8320

Phone

(910) 253-5788

Fax

(910) 253-2875

NPI assigned

Jan 5, 2007

Last updated

Mar 11, 2015By 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

Mr. David Stanley

Title

Health Director

Phone

(910) 253-2250

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Brunswick County Employee Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• County of Brunswick

  dba Brunswick County Health Services

  • State or Local Public Health Clinic/Center
  • Bolivia, NC
  • NPI 1841248622

  O20050131000387

  Same enrollment

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patricia Ellis, RD

  • Registered Dietitian
  • Bolivia, NC
  • NPI 1154584191
  NPD (past)
• Laura Michele Quarino, NP

  • Family Nurse Practitioner
  • Bolivia, NC
  • NPI 1710087226
  NPD (past)
• Victoria Edwards Smith, OBNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Bolivia, NC
  • NPI 1336144518
  NPD (past)
• Anne Wrenn, RD

  • Registered Dietitian
  • Bolivia, NC
  • NPI 1134382179
  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426032000000",
    "number": "1356498794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 STAMP ACT DR",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228320",
            "telephone_number": "910-253-5788",
            "fax_number": "910-253-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 STAMP ACT DR",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228320",
            "telephone_number": "910-253-5788",
            "fax_number": "910-253-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF BRUNSWICK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2015-03-11",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "19102532250",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS FLU",
            "identifier": "070900",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3404476",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA FLU",
            "identifier": "80888",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST FLU",
            "identifier": "194741",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brunswick County Employee Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Community Innovations, Inc.
• Comp Serv Health Resources North Carolina
• Heidi Cook, M.S. CCC-LSLP
• Caryn Marie Coons, LPC-S
• County of Brunswick (Brunswick DSS)
• County of Brunswick (Brunswick DSS)
• County of Brunswick (Brunswick County EMS)
• County of Brunswick (Brunswick County Health Services)
• Nathan Kurt Craig, DO
• Denise Anna-Marie Davies, CNM

• State or Local Public Health Clinic/Center in Bolivia, NC
• Providers in Bolivia, NC by specialty
• State or Local Public Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.