McKeithan Health, PA

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

105024 Issued in NC

Legal business name

MCKEITHAN HEALTH, PA

Practice address

3875 Business 17 E
Bolivia, NC 28422-8666

Phone

(910) 253-7990

NPI assigned

Oct 28, 2008

Organization subpart

No

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

Authorized official

Name

Edward M McKeithan

Title

Owner

Phone

(910) 253-7990

Specialties & licenses 1

Addresses

Other names 1

• Bolivia Medical Center Doing business as

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249430400000",
    "number": "1811140494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 409",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284220409",
            "telephone_number": "910-253-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3875 BUSINESS 17 E",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228666",
            "telephone_number": "910-253-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKEITHAN HEALTH, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2009-08-05",
        "status": "A",
        "authorized_official_last_name": "MCKEITHAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-253-7990"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "105024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bolivia Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Journee Rebekah Matthews
• Michael Maykish, CCC-SLP
• Tracey Nicole McCarthy, DO
• Laura Ann McDaniel O'Connell, SLP
• Jennifer Lynn McGlynn, CCC-SLP
• Edward Marvin McKeithan, NP
• Lloyd Calhoun Meeks, M.D.
• Amanda Mizelle, M.S.CCC-SLP
• Beverly Anne Montalvo, FNP
• Amanda Marie Montgomery, DPT

• Family Nurse Practitioner in Bolivia, NC
• Providers in Bolivia, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2009; 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.