NPIMap

Organization Active NPI

North Carolina Eye Ear Nose & Throat PA

Doing business as North Carolina Eye Ear Nose & Throat of Roxboro

  • Otolaryngology Physician
  • Roxboro, NC
National Provider Identifier
1861583700
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
NORTH CAROLINA EYE EAR NOSE & THROAT PA
Doing business as
North Carolina Eye Ear Nose & Throat of Roxboro
Practice address
911 Ridge Rd Ste a
Roxboro, NC 27573-4574
Phone
(336) 597-2826
Fax
(336) 597-2626
NPI assigned
Sep 27, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Jennifer L Whitehead
Title
Credentialing Coordinator
Phone
(919) 595-2143

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

911 Ridge Rd Ste a
Roxboro, NC 27573-4574

Mailing address

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

Other names 1

  • North Carolina Eye Ear Nose & Throat of Roxboro Doing business as

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": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1861583700",
    "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": "919-595-2143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 RIDGE RD STE A",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275734574",
            "telephone_number": "336-597-2826",
            "fax_number": "336-597-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA EYE EAR NOSE & THROAT PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "WHITEHEAD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "919-595-2143"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Carolina Eye Ear Nose & Throat of Roxboro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roxboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.