NPIMap

Organization Active NPI

Bladen Healthcare, LLC

Doing business as Cape Fear Valley - Bladen Medical Associates

  • Internal Medicine Physician
  • Elizabethtown, NC
National Provider Identifier
1669648143
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
H0154 Issued in NC
Legal business name
BLADEN HEALTHCARE, LLC
Doing business as
Cape Fear Valley - Bladen Medical Associates
Practice address
501 S Poplar St
Elizabethtown, NC 28337-9375
Phone
(910) 862-6308
Fax
(910) 862-5501
NPI assigned
May 5, 2008
Last updated
May 5, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
BLADEN HEALTHCARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Authorized official

Name
Mr. David Masterson
Title
Ceo
Phone
(910) 862-5178

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H0154 NC
Internal Medicine Physician 207R00000X H0154 NC Primary

Addresses

Primary practice location

501 S Poplar St
Elizabethtown, NC 28337-9375

Mailing address

300 A East McKay Street
Elizabethtown, NC 28337
Phone (910) 862-6308

Other names 1

  • Cape Fear Valley - Bladen Medical Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bladen Healthcare LLC10 organizations share this tax ID, including this one
Part of
Bladen Healthcare LLC

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1669648143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 A EAST MCKAY STREET",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "28337",
            "telephone_number": "910-862-6308",
            "fax_number": "910-862-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S POPLAR ST",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "283379375",
            "telephone_number": "910-862-6308",
            "fax_number": "910-862-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLADEN HEALTHCARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLADEN HEALTHCARE, LLC",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "MASTERSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-862-5178",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "H0154",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "H0154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cape Fear Valley - Bladen Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabethtown, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.