NPIMap

Organization Active NPI

East Carolina Health - Chowan Inc

Doing business as Vidant Chowan Hospital

  • Critical Access Hospital
  • Edenton, NC
National Provider Identifier
1467430710
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
H0063 Issued in NC
Legal business name
EAST CAROLINA HEALTH - CHOWAN INC
Doing business as
Vidant Chowan Hospital
Practice address
211 Virginia Rd
Edenton, NC 27932-9668
Phone
(252) 482-8451
Fax
(252) 482-6274
NPI assigned
Jan 6, 2006
Last updated
Feb 14, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
EAST CAROLINA HEALTH - CHOWAN INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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

Authorized official

Name
Mr. Jeffrey N. Sackrison
Title
President
Phone
(252) 482-6268

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X H0063 NC Primary

Addresses

Primary practice location

211 Virginia Rd
Edenton, NC 27932-9668

Mailing address

PO Box 629
Edenton, NC 27932-0629
Phone (252) 482-8451

Other identifiers 3

IdentifierTypeStateIssuer
3461318MedicaidNC
3451318MedicaidNC
0004WOtherNCBCBS PROVIDER #

Other names 1

  • Vidant Chowan Hospital Doing business as

National Provider Directory

National Provider Directory
Part of
East Carolina Health Chowan

Locations

105 Mark Dr
Ste A
Edenton, NC 27932
Phone (252) 482-7407

105 Mark Dr
Ste B
Edenton, NC 27932
Phone (252) 482-2134

Practitioners & affiliated clinicians

Practitioners 38

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.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329177600000",
    "number": "1467430710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279320629",
            "telephone_number": "252-482-8451",
            "fax_number": "252-482-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 VIRGINIA RD",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279329668",
            "telephone_number": "252-482-8451",
            "fax_number": "252-482-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST CAROLINA HEALTH - CHOWAN INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST CAROLINA HEALTH - CHOWAN INC",
        "enumeration_date": "2006-01-06",
        "last_updated": "2012-02-14",
        "status": "A",
        "authorized_official_last_name": "SACKRISON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-482-6268",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NC",
            "license": "H0063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3461318",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3451318",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "0004W",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vidant Chowan Hospital",
            "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 Feb 14, 2012; 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.