NPIMap

Organization Active NPI

Roanoke Valley Health Services

Doing business as Eastern Carolina Gastroenterology

  • Gastroenterology Physician
  • Roanoke Rapids, NC
National Provider Identifier
1871745158
Registry record updated Oct 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
ROANOKE VALLEY HEALTH SERVICES
Doing business as
Eastern Carolina Gastroenterology
Practice address
1108 Drake St
Roanoke Rapids, NC 27870-4948
Phone
(252) 537-9176
Fax
(252) 537-6851
NPI assigned
Oct 17, 2008
Last updated
Oct 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2008

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

Authorized official

Name
Mrs. Sherry E Jensen
Title
VP Finance
Phone
(252) 535-8005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

1108 Drake St
Roanoke Rapids, NC 27870-4948

Mailing address

1385 Medical Center Dr
Roanoke Rapids, NC 27870-5130
Phone (252) 537-9176

Other names 1

  • Eastern Carolina Gastroenterology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050119001033 NC Part B Supplier - Clinic/Group Practice 4587573159 Receives reassigned benefits from 9 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, NC; Knightdale, NC; Roanoke Rapids, NC

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1108 Drake St
Roanoke Rapids, NC 27870
Phone (252) 401-0387

Practitioners & affiliated clinicians

Practitioners 1

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": "1224201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224201600000",
    "number": "1871745158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1385 MEDICAL CENTER DR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278705130",
            "telephone_number": "252-537-9176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 DRAKE ST",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278704948",
            "telephone_number": "252-537-9176",
            "fax_number": "252-537-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROANOKE VALLEY HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-17",
        "last_updated": "2008-10-17",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "252-535-8005",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Carolina Gastroenterology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke Rapids, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.