Organization Active NPI

Carolina Age Rejuvenation Clinic

  • Family Medicine Physician
  • Morehead City, NC
National Provider Identifier
1851411912
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18859 Issued in NC
Legal business name
CAROLINA AGE REJUVENATION CLINIC
Practice address
208 Penny LN # B
Morehead City, NC 28557-4305
Phone
(252) 247-7298
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Donald Reece II, MD
Title
Doctor
Phone
(252) 247-7298

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 18859 NC Primary

Addresses

Primary practice location

208 Penny LN # B
Morehead City, NC 28557-4305

Mailing address

208 Penny LN # B
Morehead City, NC 28557-4305
Phone (252) 247-7298

National Provider Directory

National Provider Directory

Locations

208 Penny Ln
#B
Morehead City, NC 28557
Phone (252) 247-7298

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851411912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 PENNY LN # B",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285574305",
            "telephone_number": "252-247-7298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 PENNY LN # B",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285574305",
            "telephone_number": "252-247-7298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA AGE REJUVENATION CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REECE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "252-247-7298",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "18859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.