NPIMap

Organization Active NPI

Roanoke Chowan Surgery Center

  • Surgery Physician
  • Ahoskie, NC
National Provider Identifier
1417919689
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
26018 Issued in NC
Legal business name
ROANOKE CHOWAN SURGERY CENTER
Practice address
312 Academy St S
Suite a
Ahoskie, NC 27910-3200
Phone
(252) 332-6360
Fax
(252) 332-8135
NPI assigned
Apr 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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. Robert C Kahn, MDNPI 1366443558
Title
President
Phone
(252) 332-6360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 26018 NC Primary

Addresses

Primary practice location

312 Academy St S
Suite a
Ahoskie, NC 27910-3200

Mailing address

312 Academy St S
Suite a
Ahoskie, NC 27910-3200
Phone (252) 332-6360

Other identifiers 2

IdentifierTypeStateIssuer
890260CMedicaidNC
0260COtherNCBCBS

National Provider Directory

National Provider Directory

Locations

312 Academy St S
Ste A
Ahoskie, NC 27910
Phone (252) 332-6360

Practitioners & affiliated clinicians

Practitioners 1

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": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417919689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 ACADEMY ST S",
            "address_2": "SUITE A",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279103200",
            "telephone_number": "252-332-6360",
            "fax_number": "252-332-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 ACADEMY ST S",
            "address_2": "SUITE A",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279103200",
            "telephone_number": "252-332-6360",
            "fax_number": "252-332-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROANOKE CHOWAN SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KAHN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-332-6360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "26018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890260C",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0260C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ahoskie, 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.