Individual provider Active NPI

Edwin Clary Bartlett, M.D.

  • Orthopaedic Surgery Physician
  • Greenville, NC
National Provider Identifier
1720073943
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
25553 Issued in NC
Practice address
810 W H Smith Blvd
Greenville, NC 27834-3763
Phone
(252) 757-2663
Fax
(252) 317-0829
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 25553 NC Primary

Addresses

Primary practice location

810 W H Smith Blvd
Greenville, NC 27834-3763

Mailing address

810 W H Smith Blvd
Greenville, NC 27834-3763
Phone (252) 757-2663

Other identifiers 2

IdentifierTypeStateIssuer
1274070001OtherDME MAC JURISDICTION C
8913598MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
020916GAMDPharmacist
25553NCMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1720073943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 W H SMITH BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343763",
            "telephone_number": "252-757-2663",
            "fax_number": "252-317-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W H SMITH BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343763",
            "telephone_number": "252-757-2663",
            "fax_number": "252-317-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTLETT",
        "first_name": "EDWIN",
        "middle_name": "CLARY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "25553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME MAC JURISDICTION C",
            "identifier": "1274070001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8913598",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.