Ocean Isle Beach Family Medicine. PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

181477 Issued in NC

Legal business name

OCEAN ISLE BEACH FAMILY MEDICINE. PC

Practice address

120 Causeway Dr Ste 3
Ocean Isle Beach, NC 28469-7581

Phone

(910) 575-5004

Fax

(855) 575-0700

NPI assigned

Apr 3, 2012

Last updated

Oct 25, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Daniel R. Blizzard, DONPI 1437194354

Title

Physician

Phone

(910) 575-5004

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

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.

• Daniel R. Blizzard, DO

  • Family Medicine Physician
  • Ocean Isle Beach, NC
  • NPI 1437194354
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508889600000",
    "number": "1902162928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CAUSEWAY DR STE 3",
            "city": "OCEAN ISLE BEACH",
            "state": "NC",
            "postal_code": "284697581",
            "telephone_number": "910-575-5004",
            "fax_number": "855-575-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CAUSEWAY DR STE 3",
            "city": "OCEAN ISLE BEACH",
            "state": "NC",
            "postal_code": "284697581",
            "telephone_number": "910-575-5004",
            "fax_number": "855-575-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEAN ISLE BEACH FAMILY MEDICINE. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2017-10-25",
        "status": "A",
        "authorized_official_last_name": "BLIZZARD",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "910-575-5004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "181477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1902162928",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5920193",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "B502",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "34D1040435",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Calley Elizabeth Myatt
• North Carolina CVS Pharmacy LLC (CVS Pharmacy #07048)
• Novant Medical Group, Inc. (Ocean Isle Family Medicine)
• Novant Medical Group, Inc. (Seaside Orthopaedics)
• Connie Jane Numbers, LCSW, PSYD
• Karl A Odell, PHARMD
• Pamela J Owens, D.C.
• Oxygen Mental Health and Wellness Services, PLLC
• Pamela J Owens DCPC (At The Beach Chiropractic Health Center)
• Presbyterian Regional Healthcare Corp (Seaside Orthopaedics)

• Primary Care Clinic/Center in Ocean Isle Beach, NC
• Providers in Ocean Isle Beach, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2017; 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.