Carolina Heart PA

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

CAROLINA HEART PA

Practice address

804 Johns Hopkins Dr
Greenville, NC 27834-7222

Phone

(252) 757-1000

Fax

(252) 757-3045

NPI assigned

Apr 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Peter B Wagner, D.O.

Title

President

Phone

(252) 757-1000

Specialties & licenses 5

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1811953995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 JOHNS HOPKINS DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347222",
            "telephone_number": "252-757-1000",
            "fax_number": "252-757-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 JOHNS HOPKINS DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347222",
            "telephone_number": "252-757-1000",
            "fax_number": "252-757-3045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA HEART PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-757-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP NUMBER",
            "identifier": "CK0208",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890176A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER",
            "identifier": "0176A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Donor Services
• Carolina East Cardiology PC
• Carolina East Family Medicine
• Carolina East Medical Associates, Inc
• Carolina Focus
• Carolina Home Medical, Inc.
• Carolina Internal Medicine, PA
• Carolina Neurology & Electromyography PA
• Carolina Occupational Therapy of Greenville, Inc
• Carolina Physical Therapy Associates LLC

• Cardiovascular Disease Physician in Greenville, NC
• Providers in Greenville, NC by specialty
• Cardiovascular Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.