Seaside Family Practice of Beaufort, Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SEASIDE FAMILY PRACTICE OF BEAUFORT, INC.

Practice address

407 Live Oak St
Beaufort, NC 28516-1939

Phone

(252) 728-2328

Fax

(252) 728-2628

NPI assigned

Oct 25, 2007

Organization subpart

No

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

Authorized official

Name

Sherry O Kent, FNPNPI 1205812799

Title

President

Phone

(252) 728-2328

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Seaside Family Practice Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sherry Outland Kent, FNP

  • Family Nurse Practitioner
  • Beaufort, NC
  • NPI 1205812799

  NC

  Medicare reassignment Care Compare group NPD Authorized official
• Hannah Elizabeth Swindell, FNP

  • Family Nurse Practitioner
  • Beaufort, NC
  • NPI 1386399343

  NC

  Medicare reassignment Care Compare group NPD
• John Clyde Rickabaugh, MD

  • Family Medicine Physician
  • Morehead City, NC
  • NPI 1396722534
  NPD (past)

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1730368952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 LIVE OAK ST",
            "city": "BEAUFORT",
            "state": "NC",
            "postal_code": "285161939",
            "telephone_number": "252-728-2328",
            "fax_number": "252-728-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 LIVE OAK ST",
            "city": "BEAUFORT",
            "state": "NC",
            "postal_code": "285161939",
            "telephone_number": "252-728-2328",
            "fax_number": "252-728-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE FAMILY PRACTICE OF BEAUFORT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-25",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "KENT",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-728-2328",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004408",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "2807373B",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seaside Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katelynn Alise Ray, DMD
• Realo Discount Drug Stores of Eastern North Carolina Inc
• Matthew Wells Richter
• April M Risinger, P.A.
• Penny Ann Rule, L.AC
• Kelli Selfe, PHARMD
• William David Short, DMD
• Melissa B Smith
• Sound Nutrition Consulting, LLC
• Sound Pharmacy Services Inc

• All providers in Beaufort, NC
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.