NPIMap

Organization Active NPI

Beach Medical Care, LTD.

  • Family Medicine Physician
  • Nags Head, NC
National Provider Identifier
1861525404
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0190118 Issued in NC
Legal business name
BEACH MEDICAL CARE, LTD.
Practice address
4917 S Croatan Hwy
Unit 1B
Nags Head, NC 27959-8811
Phone
(252) 261-4187
Fax
(252) 261-5182
NPI assigned
Mar 13, 2007
Last updated
Oct 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Authorized official

Name
Mr. James S. Wilkinson X, M.D.NPI 1386719805
Title
President
Phone
(252) 261-4187

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X 29449 NC
Family Medicine Physician 207Q00000X 0190118 NC Primary

Addresses

Primary practice location

4917 S Croatan Hwy
Unit 1B
Nags Head, NC 27959-8811

Mailing address

PO Box 2089
Kitty Hawk, NC 27949-2089
Phone (252) 261-4187

Other identifiers 3

IdentifierTypeStateIssuer
017CJOtherNCBCBS URGENT CARE
01938OtherNCBCBS FAMILY PRACTICE
8901938MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477612800000",
    "number": "1861525404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2089",
            "city": "KITTY HAWK",
            "state": "NC",
            "postal_code": "279492089",
            "telephone_number": "252-261-4187",
            "fax_number": "252-261-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4917 S CROATAN HWY",
            "address_2": "UNIT 1B",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279598811",
            "telephone_number": "252-261-4187",
            "fax_number": "252-261-5182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACH MEDICAL CARE, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2016-10-28",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-261-4187",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "X",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NC",
            "license": "29449",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "0190118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS URGENT CARE",
            "identifier": "017CJ",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FAMILY PRACTICE",
            "identifier": "01938",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901938",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nags Head, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; 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.