NPIMap

Organization Active NPI

East Carolina Health - Chowan Inc

  • Clinic/Center
  • Edenton, NC
National Provider Identifier
1831152016
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
200200691 Issued in NC
Legal business name
EAST CAROLINA HEALTH - CHOWAN INC
Practice address
203 Earnhardt Dr
Edenton, NC 27932-8401
Phone
(252) 482-7408
Fax
(252) 482-5529
NPI assigned
Apr 10, 2006
Organization subpart
Yes
Parent organization
EAST CAROLINA HEALTH - CHOWAN INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Authorized official

Name
Mr. Jeffrey N. Sackrison
Title
President
Phone
(252) 482-6268

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 200200691 NC Primary

Addresses

Primary practice location

203 Earnhardt Dr
Edenton, NC 27932-8401

Mailing address

PO Box 569
Edenton, NC 27932-0569
Phone (252) 482-7408

Other identifiers 2

IdentifierTypeStateIssuer
012GFOtherNCBCBS PROVIDER #
89012GFMedicaidNC

Other names 1

  • Chowan Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
East Carolina Health - C8 organizations share this tax ID, including this one
Part of
East Carolina Health - C

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1831152016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 569",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279320569",
            "telephone_number": "252-482-7408",
            "fax_number": "252-482-5529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 EARNHARDT DR",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279328401",
            "telephone_number": "252-482-7408",
            "fax_number": "252-482-5529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST CAROLINA HEALTH - CHOWAN INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST CAROLINA HEALTH - CHOWAN INC",
        "enumeration_date": "2006-04-10",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "SACKRISON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-482-6268",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NC",
            "license": "200200691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "012GF",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89012GF",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chowan Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edenton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.