NPIMap

Organization Active NPI

South Whiteville Urgent Care & Family Practice PA

  • Family Medicine Physician
  • Holly Ridge, NC
National Provider Identifier
1740463140
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
29495 Issued in NC
Legal business name
SOUTH WHITEVILLE URGENT CARE & FAMILY PRACTICE PA
Practice address
308 US Highway 17 N
Holly Ridge, NC 28445-7828
Phone
(910) 264-2334
Fax
(866) 251-5115
NPI assigned
Dec 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Authorized official

Name
Dr. James Henry Pridgen, M.D.
Title
Medical Director
Phone
(910) 642-9876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 29495 NC Primary

Addresses

Primary practice location

308 US Highway 17 N
Holly Ridge, NC 28445-7828

Mailing address

326 Columbus Corners Dr
Whiteville, NC 28472-4929
Phone (910) 642-9876

Other identifiers 1

IdentifierTypeStateIssuer
89015U2MedicaidNC

National Provider Directory

National Provider Directory

Locations

308 US Highway 17 N
Holly Ridge, NC 28445
Phone (910) 264-2334

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1740463140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 COLUMBUS CORNERS DR",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284724929",
            "telephone_number": "910-642-9876",
            "fax_number": "910-642-9879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 US HIGHWAY 17 N",
            "city": "HOLLY RIDGE",
            "state": "NC",
            "postal_code": "284457828",
            "telephone_number": "910-264-2334",
            "fax_number": "866-251-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH WHITEVILLE URGENT CARE & FAMILY PRACTICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "910-642-9876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "29495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015U2",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Ridge, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; 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.