1831137330 NPI number — NEONATOLOGY & PEDIATRIC ACUTE CARE SPECIALISTS, PC

Table of content: (NPI 1831137330)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831137330 NPI number — NEONATOLOGY & PEDIATRIC ACUTE CARE SPECIALISTS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEONATOLOGY & PEDIATRIC ACUTE CARE SPECIALISTS, PC
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:
Provider Other Organization Name Type Code:
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:
1831137330
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
352 2ND ST NW
Provider Second Line Business Mailing Address:
SUITE #205
Provider Business Mailing Address City Name:
HICKORY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28601-4960
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-345-0877
Provider Business Mailing Address Fax Number:
828-345-0514

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
352 2ND ST NW
Provider Second Line Business Practice Location Address:
SUITE #205
Provider Business Practice Location Address City Name:
HICKORY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-345-0877
Provider Business Practice Location Address Fax Number:
828-345-0514
Provider Enumeration Date:
06/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CARROLL
Authorized Official First Name:
VELVET
Authorized Official Middle Name:
H
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
828-345-0877

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 9401361 . This is a "SAMUEL D WELLMAN MD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 1649254210 . This is a "SAMUEL D WELLMAN MD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 30288 . This is a "DAVID D BERRY MD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7915180 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1457335028 . This is a "DAVID D BERRY MD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8986457 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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