Individual provider Active NPI

Churchill O'Connell Bunce, PA-C

  • Surgical Physician Assistant
  • New Bern, NC
National Provider Identifier
1801359120
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0010-08810 Issued in NC
Practice address
2000 Neuse Blvd
New Bern, NC 28560-3449
Phone
(252) 633-6730
Fax
(252) 633-6740
NPI assigned
Apr 12, 2019
Last updated
Mar 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0010-08810 NC Primary

Addresses

Primary practice location

2000 Neuse Blvd
New Bern, NC 28560-3449

Mailing address

PO Box 68
Pollocksville, NC 28573-0068
Phone (252) 635-3906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190522000811 NC Practitioner - Physician Assistant 1052654696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
72.61 of 100Reported as group
Quality
57.39
Promoting interoperability
68
Improvement activities
40
Cost
77.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-08810NCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinaeast Physicians CurrentSince May 1, 2019 Accepting new patients
Carolinaeast Physicians CurrentSince May 1, 2019 Accepting new patients

Locations

532 Webb Blvd
Havelock, NC 28532
Phone (252) 447-7088

2000 Neuse Blvd
New Bern, NC 28560
Phone (252) 633-8104

137 Medical Ln
Pollocksville, NC 28573
Phone (252) 633-1010

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1801359120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "POLLOCKSVILLE",
            "state": "NC",
            "postal_code": "285730068",
            "telephone_number": "252-635-3906",
            "fax_number": "252-224-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NEUSE BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285603449",
            "telephone_number": "252-633-6730",
            "fax_number": "252-633-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNCE",
        "first_name": "CHURCHILL",
        "middle_name": "O'CONNELL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-12",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-08810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

Verify at the official NPI Registry.