1942242599 NPI number — CARTERET SURGICAL ASSOCIATES, PA

Table of content: (NPI 1942242599)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942242599 NPI number — CARTERET SURGICAL ASSOCIATES, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARTERET SURGICAL ASSOCIATES, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CAROLINAS CENTER FOR SURGERY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942242599
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/29/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3714 GUARDIAN AVE STE E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOREHEAD CITY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28557-2975
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-247-2101
Provider Business Mailing Address Fax Number:
252-247-4675

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3714 GUARDIAN AVE STE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOREHEAD CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28557-2975
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-247-2101
Provider Business Practice Location Address Fax Number:
252-247-4675
Provider Enumeration Date:
06/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HIGGINS
Authorized Official First Name:
JAMIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING
Authorized Official Telephone Number:
252-222-5865

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QS0010X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207X00000X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208800000X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01176 . This is a "BCBS NC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 39722 . This is a "NORTH CAROLINA MEDICAL BOARD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8901176 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: A6649 . This is a "RR MEDICARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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