East Cove Psychiatric Services PC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

200301170 Issued in NC

Legal business name

EAST COVE PSYCHIATRIC SERVICES PC

Practice address

1305 N Queen St
Kinston, NC 28501-2965

Phone

(252) 523-2781

Fax

(252) 523-2711

NPI assigned

Dec 27, 2007

Last updated

Nov 5, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Walter Daniel Shannon Jr., M.D.NPI 1508875394

Title

Owner/M.D.

Phone

(252) 523-2781

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Walter Daniel Shannon Jr., M.D.

  • Psychiatry Physician
  • Kinston, NC
  • NPI 1508875394
  Authorized official Same address or phone
• Joanna Wolicki-Shannon, M.D.

  • Psychiatry Physician
  • Kinston, NC
  • NPI 1245240969
  NPD

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288915200000",
    "number": "1801070719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 N QUEEN ST",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285012965",
            "telephone_number": "252-523-2781",
            "fax_number": "252-523-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 N QUEEN ST",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285012965",
            "telephone_number": "252-523-2781",
            "fax_number": "252-523-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COVE PSYCHIATRIC SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2010-11-05",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER/M.D.",
        "authorized_official_telephone_number": "252-523-2781",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": "200301170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Kinston, NC
• Providers in Kinston, NC by specialty
• Adult Mental Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.