East Carolina Health - Heritage Inc
Organization Active NPI Rural Health Clinic/Center · Pinetops, NC
NPI 1821076589 · NPPES record last updated Mar 12, 2025
Key facts
- NPI
- 1821076589
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- H0258 (NC)
- Legal business name
- EAST CAROLINA HEALTH - HERITAGE INC
- Practice address
- 1473 NC 42-43 West
Pinetops, NC 27864-7188 - Phone
- (252) 827-5231
- Fax
- (252) 827-5775
- NPI assigned
- Jan 4, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- EAST CAROLINA HEALTH - HERITAGE INC
Authorized official
- Name
- Mr. Patrick M Heins
- Title
- President
- Phone
- (252) 641-7123
Owners & managing parties with NPI records 1
Other NPIs with the same Medicare PAC ID 2
Related certifications (CCN) 1
Facilities with the same owner 7
Practitioners 68
-
Lisa Yancey Coltrane, MSN, RNCS, FNP
-
Lindsey Anne Woodlief, DNP, FNP-C
-
Joylyn Yeazell, M.D.
-
Taylor Andrew Braswell, PA-C
-
Karen Coward, M.D.
-
Jon Dubose, MD
-
Ashley Lauren Feeley, FNP-BC
-
Jermaine Angela Joefield, M.D.
-
Angela B Mebane, MD
-
Christopher Sean Motta, CRNP
-
Jennifer Joy Perry, FNP
-
Christian Finn Sorensen, M.D.
-
Stephanie Mills Wynn, RN, MSN, FNP-C
-
Paula Anne Beasley, CRNA
-
Jessica Lynn Henderson, D.O.
-
Jack Wei Lam, MD
-
Amber Varner Leggett, CRNA
-
Levi Scotty McGowan, CRNA
-
Katherine Lilley Odell, CRNA
-
Ian Scott Pratt, M.D.
-
Julian Wayne Sanford, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC
Rural health clinic certification: CCN 343400
- Legal name
- EAST CAROLINA HEALTH - HERITAGE INC
- Doing business as
- VIDANT FAMILY MEDICINE- PINETOPS
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Nov 27, 1995
- Last certification
- Jan 11, 2018
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 16, 1998 in NC
- Enrollment address
- 1473 NC 42 43 W
Pinetops, NC 27864-7188 - Related CCNs
- 340107
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Ernest L Evans |
Corporate Director | Jan 29, 2010 | |
| David S Hughes |
Corporate Officer |
Feb 6, 2012 | |
| Michelle Taylor |
Corporate Officer |
Oct 26, 2021 | |
| University Health Systems of Eastern Carolina, Inc. |
5% Or Greater Direct Ownership Interest | Jan 29, 2010 | |
| Charles E. Alford |
Corporate Officer |
Jan 14, 2001 | |
| W-2 Managing Employee | Jan 29, 2010 | ||
| Marcus Sailer Albernaz |
Corporate Director |
Apr 1, 2012 | |
| Jennifer Guerrero |
W-2 Managing Employee |
Apr 27, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100506000344 | NC | Part a Provider - Rural Health Clinic | 4789582594 | Practice locations: Pinetops, NC |
| O20120613000401 | NC | Part B Supplier - Clinic/Group Practice | 4789582594 |
Receives reassigned benefits from 23 practitioners Practice locations: Pinetops, NC |
National Provider Directory
- Part of
- East Carolina HLTH Heritage
Locations
1473 NC 42 43 W
Pinetops, NC 27864
Phone (252) 641-8585
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | H0258 | NC | Yes |
Addresses
Primary practice location
1473 NC 42-43 West
Pinetops, NC 27864-7188
Mailing address
1473 NC 42-43 West
Pinetops, NC 27864-7188
Phone (252) 827-5231
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 344625A | Medicaid | NC | |
| 0164Q | Other | NC | BCBS PROVIDER # |
| 344625C | Medicaid | NC |
Other names
- Vidant Family Medicine-Pinetops a department of Vidant Edgecombe Hospi
Other providers in Pinetops, NC
- Taylor Andrew Braswell
- Johnna Lee Brothers
- Lisa Yancey Coltrane
- Comprehensive Behavioral
- Diversified Risk Management, Inc.
- Embracing Tranquility Home Care Services LLC
- Flowers in-Home Healthcare Inc
- Halifax Medical Services PA
- Wendy Harrell
- Haven of Positive Enrichment, Inc.
All providers in Pinetops, NC · Rural Health Clinic/Center in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.