NPIMap

Organization Active NPI

Chowan Professional Services, LLC

Doing business as University Health Systems - Edenton Surgical Practice

  • Surgery Physician
  • Edenton, NC
National Provider Identifier
1396979332
Registry record updated May 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CHOWAN PROFESSIONAL SERVICES, LLC
Doing business as
University Health Systems - Edenton Surgical Practice
Practice address
203 Earnhart Dr
Suite B
Edenton, NC 27932-8401
Phone
(252) 482-6836
NPI assigned
May 5, 2009
Last updated
May 21, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
EAST CAROLINA HEALTH - CHOWAN INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2009

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

Authorized official

Name
Mr. Michael Dacus
Title
Manager
Phone
(252) 482-6175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

203 Earnhart Dr
Suite B
Edenton, NC 27932-8401

Mailing address

PO Box 377
Edenton, NC 27932-0377

Other names 1

  • University Health Systems - Edenton Surgical Practice Doing business as

National Provider Directory

National Provider Directory
Part of
East Carolina Health Chowan

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242864000000",
    "number": "1396979332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 377",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279320377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 EARNHART DR",
            "address_2": "SUITE B",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279328401",
            "telephone_number": "252-482-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOWAN PROFESSIONAL SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST CAROLINA HEALTH - CHOWAN INC.",
        "enumeration_date": "2009-05-05",
        "last_updated": "2009-05-21",
        "status": "A",
        "authorized_official_last_name": "DACUS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "252-482-6175",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Health Systems - Edenton Surgical Practice",
            "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 May 21, 2009; 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.