Marlboro Gastroenterology Associates PA

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

27767 Issued in NC

Legal business name

MARLBORO GASTROENTEROLOGY ASSOCIATES PA

Practice address

102 Endo LN
Hamlet, NC 28345-4560

Phone

(910) 205-3035

Fax

(910) 205-3062

NPI assigned

Mar 16, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Patricia J Riddle

Title

Office MGR Administrator

Phone

(843) 479-9794

Specialties & licenses 2

Addresses

Other identifiers 5

Other names 1

• MARLBORO GI ENDOSCOPY CENTER Other name

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Marlboro Gastroenterology Associates PA

  • Ambulatory Surgical Clinic/Center
  • Hamlet, NC
  • NPI 1609940352
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lester Brigman Jr., APRN BC FNP, PPCNP

  • Family Nurse Practitioner
  • Charlotte, NC
  • NPI 1245413640
  NPD (past)

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1922077403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 617",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295120617",
            "telephone_number": "843-479-6268",
            "fax_number": "843-479-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 ENDO LN",
            "city": "HAMLET",
            "state": "NC",
            "postal_code": "283454560",
            "telephone_number": "910-205-3035",
            "fax_number": "910-205-3062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLBORO GASTROENTEROLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-16",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MGR ADMINISTRATOR",
        "authorized_official_telephone_number": "843-479-9794",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SC",
            "license": "10779",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "27767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "0191F",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC1896",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC RR MEDICARE GROUP",
            "identifier": "DE8861",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890191F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CF8544",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARLBORO GI ENDOSCOPY CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Hector Luis Luna, PA-C
• Laura Marie Macri
• Siddharth Ved Malhotra, M.D.
• Charlita Mangrum, MD
• Marlboro Gastroenterology Associates PA
• Pam Marsh, COF
• Harold L Martin, MD
• Jennie Davis Maultsby, OTR/L
• Monteeia Shanta McDonald
• McLaurin Vocational Training Center, Inc

• All providers in Hamlet, NC
• Gastroenterology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.