Williamston Clinic Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WILLIAMSTON CLINIC CORP

Practice address

104 Medical Dr
Williamston, NC 27892-2156

Phone

(252) 890-6341

NPI assigned

May 27, 2005

Last updated

Jul 7, 2023By 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

Laura J Fey

Title

Sr. Director Physician Rev Cycle

Phone

(615) 221-3641

Specialties & licenses 10

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 62

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.

• Debra Ann Allenspach, CRNA

  • Certified Registered Nurse Anesthetist
  • Edenton, NC
  • NPI 1477553048
  Medicare reassignment NPD
• Annie Peaks Bonds, FNP-C

  • Family Nurse Practitioner
  • Williamston, NC
  • NPI 1861889214
  Medicare reassignment NPD
• Samantha Casper, NP-C

  • Nurse Practitioner
  • Durham, NC
  • NPI 1093280174
  Medicare reassignment NPD
• Timothy Brent Chafin, M.D.

  • Interventional Pain Medicine Physician
  • Ahoskie, NC
  • NPI 1336167733
  Medicare reassignment NPD
• Dhruva Chawla, MD

  • Nephrology Physician
  • Washington, NC
  • NPI 1245430727

  Hospitalist

  Medicare reassignment NPD
• Harsh Chawla, MD

  • Internal Medicine Physician
  • Ahoskie, NC
  • NPI 1003070350
  Medicare reassignment NPD
• Samantha Nicole Chesson Davis, FNP

  • Family Nurse Practitioner
  • Washington, NC
  • NPI 1639785074
  Medicare reassignment NPD
• Stephanie Lynn Ellis, DNP, FNP-BC

  • Nurse Practitioner
  • Washington, NC
  • NPI 1922617224
  Medicare reassignment NPD
• Spencer R Gardner, CRNA

  • Certified Registered Nurse Anesthetist
  • Williamston, NC
  • NPI 1366453185
  Medicare reassignment NPD
• James Douglas Harbin, M.D.

  • Obstetrics & Gynecology Physician
  • Washington, NC
  • NPI 1538193016
  Medicare reassignment NPD
• James Eugene Kendall Jr., MD

  • Obstetrics & Gynecology Physician
  • Tarboro, NC
  • NPI 1144205287
  Medicare reassignment NPD
• Lawrence Norman Larabee Jr., MD

  • Orthopaedic Surgery Physician
  • Kinston, NC
  • NPI 1700842291
  Medicare reassignment NPD

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1811990443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19034",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154085",
            "telephone_number": "615-221-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MEDICAL DR",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278922156",
            "telephone_number": "252-890-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSTON CLINIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "FEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR. DIRECTOR PHYSICIAN REV CYCLE",
        "authorized_official_telephone_number": "615-221-3641"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "018PT",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0725M",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89012FU",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905764",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Christian Williams, D.D.S
• Isha D Williams, PHD, LMFT
• Jovita Williams
• Elizabeth Williamson, PHARM.D.
• Williamston Chiropractic Center
• Williamston HBP Services LLC
• Williamston Hospital Corporation (Martin General Hospital)
• Williamston Hospital Corporation (Martin General Hospital)
• Williamston Hospital Corporation (Martin General Hospital)
• Williamston House

• Family Medicine Physician in Williamston, NC
• Providers in Williamston, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.