Columbus Regional Health Network
Organization Active NPI Pediatrics Physician · Whiteville, NC
NPI 1851724645 · NPPES record last updated Nov 30, 2023
Key facts
- NPI
- 1851724645
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- COLUMBUS REGIONAL HEALTH NETWORK
- Practice address
- 36 McNeill PLZ
Whiteville, NC 28472-8602 - Phone
- (910) 640-4064
- NPI assigned
- Aug 15, 2013
- Organization subpart
- Yes
- Parent organization (as reported)
- COLUMBUS REGIONAL HEALTH NETWORK
Authorized official
- Name
- Marvin Armstrong
- Title
- Cfo
- Phone
- (704) 355-2000
Other NPIs on the same Medicare enrollment 7
Practitioners 53
-
Erin Marie Balicki, PA-C
-
Allison Belle Bean, M.D.
-
Gina Marie Beaton, AGACNP-BC, FNP-BC
-
Danesh Ghiassi, MD
-
Alberto Luis Leon, M.D.
-
Lenny Luscher, PA
-
Isha Dua Mishra, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2110582 | CRHS Dba Advanced Pediatrics and Family Care | Certificate of waiver | Oct 2, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090424000511 | NC | Part B Supplier - Clinic/Group Practice | 6608924931 |
Receives reassigned benefits from 248 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Tabor City, NC; Wadesboro, NC; Whiteville, NC; Wilmington, NC; Monroe, NC; Shelby, NC; Albemarle, NC; Charlotte, NC… |
National Provider Directory
- Part of
- Christy T Perdue MD PA
Locations
612 Jefferson St
#28
Whiteville, NC 28472
Phone (910) 640-4064
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Pediatrics Physician |
208000000X | Yes |
Addresses
Primary practice location
36 McNeill PLZ
Whiteville, NC 28472-8602
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Phone (704) 631-0002
Other practice location 1
14508 James B White Hwy S
Tabor City, NC 28463-8358
Phone (910) 640-4064
Other names
- Advanced Pediatrics & Family Care
- Southeast Pediatrics
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
| Direct Messaging Address | crhs@crhn.cernerdirect.com | Columbus Regional Healthcare System, Inc. |
Other providers in Whiteville, NC
- Columbus Regional Health Network
- Columbus Regional Health Network
- Columbus Regional Health Network
- Columbus Regional Health Network
- Columbus Regional Health Network
- Columbus Regional Healthcare System
- Columbus Regional Healthcare System
- Columbus Regional Healthcare System
- Columbus Regional Healthcare System
- Columbus Rural Health Center, Inc
All providers in Whiteville, NC · Pediatrics Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.