Individual provider Active NPI

Nathan Carr Pulkingham, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Whiteville, NC
National Provider Identifier
1588663447
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
34437 Issued in NC
Practice address
500 Jefferson St
Whiteville, NC 28472-3634
Phone
(910) 642-8011
NPI assigned
Jul 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 34437 NC Primary

Addresses

Primary practice location

500 Jefferson St
Whiteville, NC 28472-3634

Mailing address

5301 Virginia Way Ste 300
Brentwood, TN 37027-7542
Phone (615) 221-4400

Other identifiers 3

IdentifierTypeStateIssuer
891293FMedicaidNC
1293FOtherNCBCBS OF NC
220033409OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041101000303 NC Practitioner - Pathology 4385606805 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Brody School of Medicine at East Carolina University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Pathologists, LLCGroup PAC ID 0648167544, 137 clinicians

Practice addresses (Care Compare)

500 Jefferson St
Whiteville, NC 28472-3634
Phone (910) 642-8011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.55 of 100Reported as group
Quality
72.42
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34437NCMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Queen City Gastroenterology & Hepatology, PC CurrentSince Apr 10, 2019 Accepting new patients
Columbus Regional Healthcare System CurrentSince Aug 1, 2020 Accepting new patients
Associated Pathologists, LLC Anatomic Pathology & Clinical Pathology CurrentSince Dec 1, 2020 Accepting new patients
Columbus Regional Healthcare System CurrentSince Aug 1, 2020 Accepting new patients
Progressive Pathology LLC Anatomic Pathology & Clinical Pathology Past Accepting new patients
Nathan Carr Pulkingham MD PA Anatomic Pathology & Clinical Pathology Past Accepting new patients
Associated Pathologists LLC Past Accepting new patients

Locations

1901 Phoenix Blvd
Atlanta, GA 30349
Phone (770) 991-0913

200 Allen Memorial Dr
Bremen, GA 30110
Phone (770) 537-5851

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

821 N Cobb St
Milledgeville, GA 31061
Phone (478) 454-3500

601 Dallas Hwy
Villa Rica, GA 30180
Phone (770) 456-3000

320 Lillington Ave
Ste 101
Charlotte, NC 28204
Phone (704) 332-1574

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

500 Jefferson St
Whiteville, NC 28472
Phone (910) 642-1776

5301 Virginia Way
Ste 300
Brentwood, TN 37027
Phone (615) 695-4977

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

1010 Airpark Center Dr
Nashville, TN 37217
Phone (615) 221-4447

Interoperability endpoints

  • Direct secure messaging: npulkingham@crhn.cernerdirect.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1588663447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 VIRGINIA WAY STE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277542",
            "telephone_number": "615-221-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 JEFFERSON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723634",
            "telephone_number": "910-642-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULKINGHAM",
        "first_name": "NATHAN",
        "middle_name": "CARR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "34437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891293F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "1293F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "220033409",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

Verify at the official NPI Registry.