Organization Active NPI

Crystal Coast Radiation Oncology

  • Radiation Oncology Physician
  • New Bern, NC
National Provider Identifier
1417955097
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
CRYSTAL COAST RADIATION ONCOLOGY
Practice address
2000 Neuse Blvd
New Bern, NC 28560-3449
Phone
(252) 633-8730
Fax
(252) 633-8736
NPI assigned
Jul 8, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Christopher August Philippart, MD
Title
President
Phone
(252) 634-9901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X NC Primary

Addresses

Primary practice location

2000 Neuse Blvd
New Bern, NC 28560-3449

Mailing address

1425 S Glenburnie Rd
Suite 6
New Bern, NC 28562-2610
Phone (252) 634-9901

Other identifiers 2

IdentifierTypeStateIssuer
8902713MedicaidNC
02713OtherNCBCBS NC GROUP NUMBER

National Provider Directory

National Provider Directory

Locations

1425 S Glenburnie Rd
Ste 6
New Bern, NC 28562
Phone (252) 634-9901

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": "1120780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1417955097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 S GLENBURNIE RD",
            "address_2": "SUITE 6",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622610",
            "telephone_number": "252-634-9901",
            "fax_number": "252-634-9946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NEUSE BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285603449",
            "telephone_number": "252-633-8730",
            "fax_number": "252-633-8736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL COAST RADIATION ONCOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PHILIPPART",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "AUGUST",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-634-9901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902713",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC GROUP NUMBER",
            "identifier": "02713",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.