Greater Carolina Ear Nose &Throat P.a.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

GREATER CAROLINA EAR NOSE &THROAT P.A.

Practice address

4315 Ludgate St
Lumberton, NC 28358-2460

Phone

(910) 738-1919

Fax

(910) 738-1991

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Anita Louise Jackson, M.D., M.P.H

Title

Owner

Phone

(910) 738-1919

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1821179037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 LUDGATE STREET",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582460",
            "telephone_number": "910-738-1919",
            "fax_number": "910-738-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 LUDGATE ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582460",
            "telephone_number": "910-738-1919",
            "fax_number": "910-738-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER CAROLINA EAR NOSE &THROAT P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-738-1919",
        "authorized_official_credential": "M.D., M.P.H"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0215Y",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890215Y",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DQ4495",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "103883",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barry Gerard Graham, PA-C
• Chandra Jeanne Graham, LPC
• Charles Graham
• Kevin Eugene Graham, MSW, LCAS
• Zoe Rose Naumburg Gravitz, MD
• Ashley Green, RD, LDN
• Jordan Renee Greenway, MD
• Teva Melvin Greenwood, CPNP-PC
• Gregory Nathaniel Griffin, DO
• Barden Grimes, LCAS.,CCS

• Medical Specialty Clinic/Center in Lumberton, NC
• Providers in Lumberton, NC by specialty
• Medical Specialty Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.