Active NPI
Bernard Leroy Langston III, MD
- Family Medicine Physician
- Supply, NC
National Provider Identifier
1821066358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 27938
- Practice address
- 2930 Holden Beach Rd SW
Supply, NC 28462-5702 - Phone
- (910) 842-5991
- Fax
- (910) 842-5994
- NPI assigned
- Mar 10, 2006
- Last updated
- May 3, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 27938 | NC | Primary |
Addresses
Primary practice location
2930 Holden Beach Rd SW
Supply, NC 28462-5702
Mailing address
2930 Holden Beach Rd SW
Supply, NC 28462-5702
Phone (910) 842-5991
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8950904 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27938 | NC | MD | Ambulatory Care Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urgent Care Centers of Carolina, Inc. | Past | Accepting new patients | |
| Chicora Medical Group PA | Past | Accepting new patients | |
| Ucb Properties LLC | Family Medicine | Past | Accepting new patients |
| Chicora Medical Group PA | Family Medicine | Past | Accepting new patients |
Organizations & group practices 5
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.
-
- Pulmonary Disease Physician
- Shallotte, NC
- NPI 1770552119
-
dba Brunswick Speciality Services
- Family Medicine Physician
- Supply, NC
- NPI 1881663227
-
dba Holden Beach Medical Center
- Family Medicine Physician
- Supply, NC
- NPI 1306815741
-
- Urgent Care Clinic/Center
- Burlington, NC
- NPI 1235214123
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493769600000",
"number": "1821066358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2930 HOLDEN BEACH RD SW",
"city": "SUPPLY",
"state": "NC",
"postal_code": "284625702",
"telephone_number": "910-842-5991",
"fax_number": "910-842-5994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2930 HOLDEN BEACH RD SW",
"city": "SUPPLY",
"state": "NC",
"postal_code": "284625702",
"telephone_number": "910-842-5991",
"fax_number": "910-842-5994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGSTON",
"first_name": "BERNARD",
"middle_name": "LEROY",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-10",
"last_updated": "2017-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "27938",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8950904",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Supply, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.