NPIMap

Organization Active NPI

County of Pender

  • State or Local Public Health Clinic/Center
  • Burgaw, NC
National Provider Identifier
1508887076
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
COUNTY OF PENDER
Practice address
298 Progress Dr
Burgaw, NC 28425-4618
Phone
(910) 259-1230
Fax
(910) 259-2138
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Authorized official

Name
Carolyn Jean Moser
Title
Health Director
Phone
(910) 259-1499

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NC
Community Health Clinic/Center 261QC1500X NC
Dental Clinic/Center 261QD0000X NC
Non-Surgical Family Planning Clinic/Center 261QF0050X NC
Medical Specialty Clinic/Center 261QM2500X NC
State or Local Public Health Clinic/Center 261QP0905X NC Primary
Primary Care Clinic/Center 261QP2300X NC
Clinical Medical Laboratory 291U00000X 34D0676319 NC
Clinic Pharmacy 3336C0002X NC

Addresses

Primary practice location

298 Progress Dr
Burgaw, NC 28425-4618

Mailing address

298 Progress Dr
Burgaw, NC 28425-4618
Phone (910) 259-1230

Other identifiers 3

IdentifierTypeStateIssuer
3404371MedicaidNC
3404424MedicaidNC
0721HOtherNCBCBSNC

Other names 2

  • COUNTY OF PENDER Other name
  • Pender County Health Department Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090821000182 NC Part B Supplier - Clinic/Group Practice 7214081421 Receives reassigned benefits from 5 practitioners
Practice locations: Burgaw, NC

National Provider Directory

National Provider Directory
Tax ID family
Pender County Dept of Social Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Locations

5380 NC Highway 53 W
Burgaw, NC 28425

10750 NC Highway 53 W
Burgaw, NC 28425
Phone (910) 283-5626

15060 US Highway 17
Hampstead, NC 28443

Practitioners & affiliated clinicians

Practitioners 5

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": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1508887076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 PROGRESS DR",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "284254618",
            "telephone_number": "910-259-1230",
            "fax_number": "910-259-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 PROGRESS DR",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "284254618",
            "telephone_number": "910-259-1230",
            "fax_number": "910-259-2138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF PENDER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "MOSER",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "910-259-1499"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NC",
            "license": "34D0676319",
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3404371",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3404424",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "0721H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COUNTY OF PENDER",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Pender County Health Department",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Pender County Health Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Burgaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.