Carolina Express Care Selma

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

101583 Issued in NC

Legal business name

CAROLINA EXPRESS CARE SELMA

Practice address

108 S Raiford St
Selma, NC 27576-3155

Phone

(919) 217-1411

Fax

(919) 217-3084

NPI assigned

Nov 1, 2006

Last updated

Aug 22, 2020By 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

Dale White

Title

Ceo

Phone

(919) 217-1411

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Carolina Express Care Dba Zebulon Family Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Carolina Express Care Dba Zebulon Family Medicine

  • Family Medicine Physician
  • Zebulon, NC
  • NPI 1285718924
  NPD tax ID

Locations

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972680080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 MCKNIGHT DR",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457050",
            "telephone_number": "919-217-1411",
            "fax_number": "919-217-3084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S RAIFORD ST",
            "city": "SELMA",
            "state": "NC",
            "postal_code": "275763155",
            "telephone_number": "919-217-1411",
            "fax_number": "919-217-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA EXPRESS CARE SELMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-217-1411"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "101583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015EF",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridge to Tomorrow LLC.
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• Judith Batamuliza Bushaija, MSW LCSWA
• Laura Ann Caldarera, LPC, LCAS
• Lagreta Williams Cameron, LCSWA, LCASA
• Carolina Support Services, Inc
• Carslist LLC (Safecare Transport)
• Laney Casey
• Children First Hope Services
• Christian Home Care

• Medical Physician Assistant in Selma, NC
• Providers in Selma, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.