NPIMap

Organization Active NPI

Carolina Orthopedic and Sports Medicine Inc

  • Orthopaedic Surgery Physician
  • Havelock, NC
National Provider Identifier
1700070356
Registry record updated Aug 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
142144 Issued in NC
Legal business name
CAROLINA ORTHOPEDIC AND SPORTS MEDICINE INC
Practice address
600D Fontana Blvd
Havelock, NC 28532-3104
Phone
(252) 634-2676
Fax
(252) 633-3502
NPI assigned
Aug 28, 2007
Last updated
Aug 20, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINA ORTHOPEDIC AND SPORTS MEDICINE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 20, 2008

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

Authorized official

Name
Dawn D Garrett
Title
Executive Director
Phone
(252) 634-2676

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 142144 NC Primary
Physical Therapist 225100000X 142144 NC
Occupational Therapist 225X00000X 142144 NC

Addresses

Primary practice location

600D Fontana Blvd
Havelock, NC 28532-3104

Mailing address

738 Newman Rd
New Bern, NC 28562-5238
Phone (252) 634-2676

Other identifiers 2

IdentifierTypeStateIssuer
019K4OtherNCBCBS
7200149MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Carolina Orthopedic and Sports Medicine Inc - Kinston6 organizations share this tax ID, including this one
Part of
Carolina Orthopedic and Sports Medicine Inc - Kinston

Other organizations with this tax ID 5

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

Locations

600D Fontana Blvd
Havelock, NC 28532
Phone (252) 444-5600

738 Newman Rd
New Bern, NC 28562
Phone (252) 633-0361

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1700070356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "738 NEWMAN RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625238",
            "telephone_number": "252-634-2676",
            "fax_number": "252-633-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600D FONTANA BLVD",
            "city": "HAVELOCK",
            "state": "NC",
            "postal_code": "285323104",
            "telephone_number": "252-634-2676",
            "fax_number": "252-633-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA ORTHOPEDIC AND SPORTS MEDICINE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINA ORTHOPEDIC AND SPORTS MEDICINE INC",
        "enumeration_date": "2007-08-28",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "252-634-2676"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "142144",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "142144",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "142144",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "019K4",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7200149",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Havelock, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.