Urology Clinic of Jacksonville NC Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

32127 Issued in NC

Legal business name

UROLOGY CLINIC OF JACKSONVILLE NC INC

Practice address

260 Memorial Dr
Jacksonville, NC 28546-6332

Phone

(910) 355-0900

Fax

(910) 355-1940

NPI assigned

Sep 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Booker T. Keyes Jr., M DNPI 1568551844

Title

Urologist

Phone

(910) 355-0900

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Booker T Keyes Jr., M.D.

  • Urology Physician
  • Jacksonville, NC
  • NPI 1568551844
  NPD (past) Authorized official

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1588765481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 MEMORIAL DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466332",
            "telephone_number": "910-355-0900",
            "fax_number": "910-355-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 MEMORIAL DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466332",
            "telephone_number": "910-355-0900",
            "fax_number": "910-355-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY CLINIC OF JACKSONVILLE NC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "KEYES",
        "authorized_official_first_name": "BOOKER",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "UROLOGIST",
        "authorized_official_telephone_number": "910-355-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": "32127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kali Tyson
• Judith Uhrick, MSW, ACSW, LCSW
• Carmela Underwood, RN,IBCLC
• United Home Care, Inc.
• Until Grace Counseling, PLLC
• Ursula White
• Kaylyn Vaillancourt, PT, DPT
• Ivelisse M Valentin, MA, BCBA, LBA
• Karen Esbeidy Valentine, MSW
• Melissa Vallario

• Specialist in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; 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.