Organization Active NPI

Healtheast Family Care of Nags Head

  • Family Medicine Physician
  • Nags Head, NC
National Provider Identifier
1386620060
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HEALTHEAST FAMILY CARE OF NAGS HEAD
Practice address
4810 S Croatan Highway
Suite 100
Nags Head, NC 27959
Phone
(252) 441-3177
Fax
(252) 441-2271
NPI assigned
Dec 15, 2005
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
Mrs. Vonda Getrude Leffler
Title
Practice Manager
Phone
(252) 441-3177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X NC Primary

Addresses

Primary practice location

4810 S Croatan Highway
Suite 100
Nags Head, NC 27959

Mailing address

4810 S Croatan Highway
Suite 100
Nags Head, NC 27959
Phone (252) 441-3177

Other identifiers 2

IdentifierTypeStateIssuer
890314EMedicaidNC
0314EOtherNCBCBS OF NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386620060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4810 S CROATAN HIGHWAY",
            "address_2": "SUITE 100",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "27959",
            "telephone_number": "252-441-3177",
            "fax_number": "252-441-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 S CROATAN HIGHWAY",
            "address_2": "SUITE 100",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "27959",
            "telephone_number": "252-441-3177",
            "fax_number": "252-441-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHEAST FAMILY CARE OF NAGS HEAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEFFLER",
        "authorized_official_first_name": "VONDA",
        "authorized_official_middle_name": "GETRUDE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "252-441-3177",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890314E",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "0314E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nags Head, 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.