Active NPI
Ecep II PA
- Emergency Medicine Physician
- Wilmington, NC
National Provider Identifier
1831265263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- ECEP II PA
- Practice address
- 2131 S 17TH St
Wilmington, NC 28401-7407 - Phone
- (843) 237-3378
- Fax
- (843) 237-5073
- NPI assigned
- Nov 28, 2006
- Last updated
- Oct 12, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dale Key
- Title
- Administrator
- Phone
- (910) 202-3363
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary |
Addresses
Primary practice location
2131 S 17TH St
Wilmington, NC 28401-7407
Mailing address
4402 Shipyard Blvd
Wilmington, NC 28403-6161
Phone (910) 202-3363
Other names 1
- Eastern Carolina Emergency Physicians II PA
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040413000773 | NC | Part B Supplier - Clinic/Group Practice | 5092709931 |
Receives reassigned benefits from 95 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Wilmington, NC; Burgaw, NC |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 36
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.
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- Emergency Medicine Physician
- Wilmington, NC
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- Physician Assistant
- Wilmington, NC
- NPI 1285241083
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- Wilmington, NC
- NPI 1790880342
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- Physician Assistant
- Jacksonville, NC
- NPI 1629608039
-
- Physician Assistant
- Wilmington, NC
- NPI 1356075352
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- Physician Assistant
- Wilmington, NC
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1602460800000",
"number": "1831265263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4402 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284036161",
"telephone_number": "910-202-3363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2131 S 17TH ST",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017407",
"telephone_number": "843-237-3378",
"fax_number": "843-237-5073"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ECEP II PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-28",
"last_updated": "2020-10-12",
"certification_date": "2020-10-12",
"status": "A",
"authorized_official_last_name": "KEY",
"authorized_official_first_name": "DALE",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "910-202-3363"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Eastern Carolina Emergency Physicians II PA",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Eastern Carolina Emergency Physicians II PA",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.