Organization Active NPI

Mid Atlantic Neurology & Sleep Medicine, P.a.

  • Neurology Physician
  • Jacksonville, NC
National Provider Identifier
1669708665
Registry record updated Oct 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
MID ATLANTIC NEUROLOGY & SLEEP MEDICINE, P.A.
Practice address
227 Memorial Dr
Jacksonville, NC 28546-6333
Phone
(910) 353-3624
Fax
(910) 353-0050
NPI assigned
Oct 26, 2009
Organization subpart
Yes
Parent organization
MID ATLANTIC NEUROLOGY & SLEEP MEDICINE, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 26, 2009

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

Authorized official

Name
Khaled F Jreisat, MD
Title
President
Phone
(252) 474-3863

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

227 Memorial Dr
Jacksonville, NC 28546-6333

Mailing address

PO Box 12067
New Bern, NC 28561-2067

National Provider Directory

National Provider Directory
Part of
Mid Atlantic Neurology Sle

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256515200000",
    "number": "1669708665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12067",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285612067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 MEMORIAL DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466333",
            "telephone_number": "910-353-3624",
            "fax_number": "910-353-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID ATLANTIC NEUROLOGY & SLEEP MEDICINE, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MID ATLANTIC NEUROLOGY & SLEEP MEDICINE, P.A.",
        "enumeration_date": "2009-10-26",
        "last_updated": "2009-10-26",
        "status": "A",
        "authorized_official_last_name": "JREISAT",
        "authorized_official_first_name": "KHALED",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-474-3863",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.