NPIMap

Organization Active NPI

North Carolina Eye Ear Nose & Throat PA

  • Otolaryngology Physician
  • Durham, NC
National Provider Identifier
1851424261
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
NA Issued in NC
Legal business name
NORTH CAROLINA EYE EAR NOSE & THROAT PA
Practice address
4102 N Roxboro St
Durham, NC 27704-2122
Phone
(919) 595-2000
Fax
(919) 595-2190
NPI assigned
Mar 14, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Melissa B Myers
Title
Patient Accounting Manager
Phone
(919) 595-2106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X NA NC Primary

Addresses

Primary practice location

4102 N Roxboro St
Durham, NC 27704-2122

Mailing address

4102 N Roxboro St
Durham, NC 27704-2122
Phone (919) 595-2000

Other identifiers 2

IdentifierTypeStateIssuer
890248AMedicaidNY
0248AOtherNCBCBSNC-OTOLARYNGOLOGY

National Provider Directory

National Provider Directory
Tax ID family
North Carolina Eye Ear Nose Throat PA5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851424261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042122",
            "telephone_number": "919-595-2000",
            "fax_number": "919-595-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042122",
            "telephone_number": "919-595-2000",
            "fax_number": "919-595-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA EYE EAR NOSE & THROAT PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PATIENT ACCOUNTING MANAGER",
        "authorized_official_telephone_number": "919-595-2106"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890248A",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC-OTOLARYNGOLOGY",
            "identifier": "0248A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, 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.