NPIMap

Organization Active NPI

Bladen County Hospital

  • Emergency Care Clinic/Center
  • Elizabethtown, NC
National Provider Identifier
1720013162
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
License
H0154 Issued in NC
Legal business name
BLADEN COUNTY HOSPITAL
Practice address
501 S Poplar St
Elizabethtown, NC 28337-9375
Phone
(910) 862-5100
Fax
(910) 862-1238
NPI assigned
Jul 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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) 862-5179

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X H0154 NC Primary

Addresses

Primary practice location

501 S Poplar St
Elizabethtown, NC 28337-9375

Mailing address

PO Box 398
Elizabethtown, NC 28337-0398
Phone (910) 862-5100

Other identifiers 2

IdentifierTypeStateIssuer
0766MOtherNCBCBS -ER PHYSICIAN
890766MMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Bladen County Hospital4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720013162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 398",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "283370398",
            "telephone_number": "910-862-5100",
            "fax_number": "910-862-1238"
        },
        {
            "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": "910-862-5100",
            "fax_number": "910-862-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLADEN COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MASTERSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-862-5179",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "NC",
            "license": "H0154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS -ER PHYSICIAN",
            "identifier": "0766M",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890766M",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.