NPIMap

Organization Active NPI

Beaufort Regional Physicians, LLC

  • Family Medicine Physician
  • Chocowinity, NC
National Provider Identifier
1538275706
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BEAUFORT REGIONAL PHYSICIANS, LLC
Practice address
740 Bragaw Lane
Chocowinity, NC 27817-8415
Phone
(252) 946-9562
Fax
(252) 946-9071
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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

Authorized official

Name
Mrs. Susan S Gerard
Title
Physician Practice Administrator
Phone
(252) 975-4203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

740 Bragaw Lane
Chocowinity, NC 27817-8415

Mailing address

740 Bragaw Lane
Chocowinity, NC 27817-8415
Phone (252) 946-9562

Other identifiers 2

IdentifierTypeStateIssuer
89016A5MedicaidNC
022T3OtherNCBLUE CROSS BLUE SHIELD

Other names 1

  • CHOCOWINITY FAMILY CARE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beaufort County Hospital Assn Inc27 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1538275706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 BRAGAW LANE",
            "city": "CHOCOWINITY",
            "state": "NC",
            "postal_code": "278178415",
            "telephone_number": "252-946-9562",
            "fax_number": "252-946-9071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 BRAGAW LANE",
            "city": "CHOCOWINITY",
            "state": "NC",
            "postal_code": "278178415",
            "telephone_number": "252-946-9562",
            "fax_number": "252-946-9071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUFORT REGIONAL PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "GERARD",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "252-975-4203",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89016A5",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "022T3",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHOCOWINITY FAMILY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chocowinity, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; 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.