Beckford Avenue Medical Center PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23579 Issued in NC

Legal business name

BECKFORD AVENUE MEDICAL CENTER PA

Practice address

816 US Hwy 158 W Suite 102
Warrenton, NC 27589

Phone

(252) 257-6213

Fax

(252) 257-3286

NPI assigned

Sep 6, 2006

Organization subpart

No

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

Authorized official

Name

James E Kenney, M.D.NPI 1639177249

Title

President

Phone

(252) 257-6213

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Beckford Warren Medical center Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Beckford Avenue Medical Center PA

  • Family Medicine Physician
  • Henderson, NC
  • NPI 1679571574

  O20050325000700

  Same enrollment

Locations

Practitioners 3

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

• James E Kenney, M.D.

  • Family Medicine Physician
  • Henderson, NC
  • NPI 1639177249

  Family Medicine, NC

  Medicare reassignment Care Compare group NPD Authorized official
• Francis C Aniekwensi, M.D.

  • Family Medicine Physician
  • Henderson, NC
  • NPI 1316054364

  NC

  Medicare reassignment Care Compare group
• Maggie King-Harris, NP

  • Family Nurse Practitioner
  • Warrenton, NC
  • NPI 1427810621

  NC

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1972606820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 US HWY 158 W SUITE 102",
            "city": "WARRENTON",
            "state": "NC",
            "postal_code": "27589",
            "telephone_number": "252-257-6213",
            "fax_number": "252-257-3286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 US HWY 158 W SUITE 102",
            "city": "WARRENTON",
            "state": "NC",
            "postal_code": "27589",
            "telephone_number": "252-257-6213",
            "fax_number": "252-257-3286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BECKFORD AVENUE MEDICAL CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2024-05-08",
        "certification_date": "2024-04-05",
        "status": "A",
        "authorized_official_last_name": "KENNEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-257-6213",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "23579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015AY",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beckford Warren Medical center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beckford Warren Medical center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alston Bright Start Mental Health
• Shalonda Alston, LCSW
• Tonya Marie Alston
• Jarrett Lee Barnett, PHARMD
• Derick Nathaniel Bayersdorfer, COTA
• Bio-Medical Applications of North Carolina, Inc.
• Cessel Jewon Boyd, MA, LCMHC, LPC
• Romine Branch
• Chelsea Lea Britt
• Jillian Bullock, C.N.A 1

• All providers in Warrenton, NC
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.