Active NPI
Atlantic Urology PC
- Urology Physician
- Supply, NC
National Provider Identifier
1376649830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- ATLANTIC UROLOGY PC
- Practice address
- 20 Medical Campus Dr
Suite 202
Supply, NC 28462-4096 - Phone
- (910) 362-8765
- NPI assigned
- Sep 15, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Richard Mynatt, M.D
- Title
- Owner M.D
- Phone
- (910) 362-8765
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | Primary |
Addresses
Primary practice location
20 Medical Campus Dr
Suite 202
Supply, NC 28462-4096
Mailing address
PO Box 30727
Charlotte, NC 28230-0727
Phone (910) 362-8765
National Provider Directory
National Provider Directory- Tax ID family
- Atlantic Urology PC
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Urology Physician
- Southport, NC
- NPI 1073770939
-
- Urology Physician
- Hampstead, NC
- NPI 1497995518
-
- Urology Physician
- Wilmington, NC
- NPI 1851498208
Locations
20 Medical Campus Dr NW
Ste 202
Supply, NC 28462
Phone (910) 755-5565
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1376649830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30727",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282300727",
"telephone_number": "910-362-8765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 MEDICAL CAMPUS DR",
"address_2": "SUITE 202",
"city": "SUPPLY",
"state": "NC",
"postal_code": "284624096",
"telephone_number": "910-362-8765"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATLANTIC UROLOGY PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-15",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MYNATT",
"authorized_official_first_name": "RICHARD",
"authorized_official_title_or_position": "OWNER M.D",
"authorized_official_telephone_number": "910-362-8765",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Supply, NC
- Allan Hiroshi Andrews, M.D.
- Kathy Jo Asbury, ARNP
- June Carol Asher, COTA/L
- Atlantic Internal Medicine PA
- Atlantic Neurology and Sleep Medicine,PLLC
- Avid Health at Home North Carolina (Avid Health at Home NC)
- Diane Nicole Ballerino-Regan, M.D.
- Tara Baran, OTR
- Mary Beth Barna, PNP-BC
- Otis Jeffrey Baty, PNP
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.