Eastern Carolina Internal Medicine PA

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

REGISTRATION39206 Issued in NC

Legal business name

EASTERN CAROLINA INTERNAL MEDICINE PA

Practice address

2604 Dr Martin Luther King Jr Blvd
New Bern, NC 28562

Phone

(252) 636-1919

Fax

(252) 636-2656

NPI assigned

Nov 14, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Craig A Holton

Title

Chief Operating Officer

Phone

(252) 633-1010

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Pediatrics Other name

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497827794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13187",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285613187",
            "telephone_number": "252-636-1919",
            "fax_number": "252-636-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 DR MARTIN LUTHER KING JR BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "28562",
            "telephone_number": "252-636-1919",
            "fax_number": "252-636-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN CAROLINA INTERNAL MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLTON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "252-633-1010"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NC",
            "license": "REGISTRATION39206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890235U",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "01907",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatrics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Easter Seals Ucp North Carolina and Virginia
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• Eastern Carolina Glaucoma and Vision Center
• Eastern Carolina Health Resources
• Eastern Carolina Internal Medicine PA
• Eastern Carolina Internal Medicine PA
• Eastern Carolina Internal Medicine PA
• Eastern Carolina Wellness Group
• Eastern Carolina Women's Center, PA
• Eastern Carolina Young Men's Christian Association, Inc.

• Multi-Specialty Clinic/Center in New Bern, NC
• Providers in New Bern, NC by specialty
• Multi-Specialty Clinic/Center in North Carolina

• 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.