East Carolina Health-Bertie
Organization Active NPI Emergency Medicine Physician · Windsor, NC
NPI 1619955705 · NPPES record last updated Mar 18, 2026
Key facts
- NPI
- 1619955705
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- H0268 (NC)
- Legal business name
- EAST CAROLINA HEALTH-BERTIE
- Practice address
- 1403 S King St
Windsor, NC 27983-9666 - Phone
- (252) 794-6685
- Fax
- (252) 794-6771
- NPI assigned
- Jan 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Brian J Harvill
- Title
- President
- Phone
- (252) 794-6600
Other NPIs on the same Medicare enrollment 1
Member of 1
Practitioners 13
-
Ryan James Fouche, D.O.
-
Teddie Wayne Gore, FNP
-
Rudo Gwanzura, MD
-
Phillip Gordon Harris, M.D.
-
Brian P Lowry, MD
-
Michael Lowry, MD
-
Samuel Moskowitz, M.D.
-
Kimberly Rouse Smith, M.D.
-
Douglas John Snyder, M.D.
-
Shawn Michael Wagner, PHYSICIAN ASSISTANT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041112000143 | NC | Part B Supplier - Clinic/Group Practice | 1355251661 |
Receives reassigned benefits from 43 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Windsor, NC |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | H0268 | NC | Yes |
Addresses
Primary practice location
1403 S King St
Windsor, NC 27983-9666
Mailing address
PO Box 509
Windsor, NC 27983-0509
Phone (252) 794-6685
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020VP | Other | NC | BCBS |
| 5950582 | Medicaid | NC |
Other names
- Professional ED Billing Bertie Memorial Hospital
Other providers in Windsor, NC
- Down East Home Care Agency, Inc.
- East Carolina Health-Bertie
- East Carolina Health-Bertie
- East Carolina Health-Bertie
- East Carolina Health-Bertie
- Eastern Home Health Care, Inc.
- Faithful House
- Charles Olufemi Folashade
- Erica Michelle Ford
- Gladys Cherry
All providers in Windsor, NC · Emergency Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.