NPIMap

Organization Active NPI

East Carolina Health-Chowan Inc

  • Family Medicine Physician
  • Edenton, NC
National Provider Identifier
1629239488
Registry record updated Dec 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EAST CAROLINA HEALTH-CHOWAN INC
Practice address
201 Virginia Rd
Edenton, NC 27932-9668
Phone
(252) 482-2116
Fax
(252) 482-7631
NPI assigned
Jun 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2008

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

Authorized official

Name
Mr. Jeffery N. Sackrison
Title
President
Phone
(252) 482-6268

Specialties & licenses 1

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

Addresses

Primary practice location

201 Virginia Rd
Edenton, NC 27932-9668

Mailing address

PO Box 569
Edenton, NC 27932-0569
Phone (252) 482-2116

Other identifiers 2

IdentifierTypeStateIssuer
019Y1OtherNCBCBS
5950347MedicaidNC

Other names 1

  • Chowan Hospital Family Practice Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228953600000",
    "number": "1629239488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 569",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279320569",
            "telephone_number": "252-482-2116",
            "fax_number": "252-482-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 VIRGINIA RD",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279329668",
            "telephone_number": "252-482-2116",
            "fax_number": "252-482-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST CAROLINA HEALTH-CHOWAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2008-12-11",
        "status": "A",
        "authorized_official_last_name": "SACKRISON",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-482-6268",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "019Y1",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950347",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chowan Hospital Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edenton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; 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.