Organization Active NPI

North River Primecare PC

  • Adult Health Nurse Practitioner
  • Beaufort, NC
National Provider Identifier
1457541484
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
900119 Issued in NC
Legal business name
NORTH RIVER PRIMECARE PC
Practice address
301 Jones Ave
Beaufort, NC 28516-1514
Phone
(252) 728-3252
Fax
(252) 728-3251
NPI assigned
Jul 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Authorized official

Name
Laura H. Gaulden, ANP
Title
Owner
Phone
(252) 728-3252

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X 200400309 NC
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X 900119 NC Primary

Addresses

Primary practice location

301 Jones Ave
Beaufort, NC 28516-1514

Mailing address

301 Jones Ave
Beaufort, NC 28516-1514
Phone (252) 728-3252

Other identifiers 1

IdentifierTypeStateIssuer
5907341MedicaidNC

National Provider Directory

National Provider Directory

Locations

444 Harkers Island Rd
Beaufort, NC 28516
Phone (252) 728-3252

Practitioners & affiliated clinicians

Practitioners 2

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": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1457541484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 JONES AVE",
            "city": "BEAUFORT",
            "state": "NC",
            "postal_code": "285161514",
            "telephone_number": "252-728-3252",
            "fax_number": "252-728-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 JONES AVE",
            "city": "BEAUFORT",
            "state": "NC",
            "postal_code": "285161514",
            "telephone_number": "252-728-3252",
            "fax_number": "252-728-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH RIVER PRIMECARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "GAULDEN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-728-3252",
        "authorized_official_credential": "ANP"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "200400309",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "900119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5907341",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.