Individual provider Active NPI

Henry John Macdonald Jr., M.D.

  • Otolaryngology Physician
  • New Bern, NC
National Provider Identifier
1992744791
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
16432 Issued in NC
Practice address
3110 Wellons Blvd
New Bern, NC 28562-5247
Phone
(252) 638-2515
Fax
(252) 638-8538
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 16432 NC Primary

Addresses

Primary practice location

3110 Wellons Blvd
New Bern, NC 28562-5247

Mailing address

3110 Wellons Blvd
New Bern, NC 28562-5247
Phone (252) 638-2515

Other identifiers 1

IdentifierTypeStateIssuer
8953662MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16432NCMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Ear Nose & Throat Associates PLLC Otolaryngology PastSince May 20, 2005 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1992744791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 WELLONS BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625247",
            "telephone_number": "252-638-2515",
            "fax_number": "252-638-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 WELLONS BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625247",
            "telephone_number": "252-638-2515",
            "fax_number": "252-638-8538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "HENRY",
        "middle_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "16432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8953662",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; 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.