1891944195 NPI number — FOOT & ANKLE INSTITUTE OF THE CAROLINAS, PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891944195 NPI number — FOOT & ANKLE INSTITUTE OF THE CAROLINAS, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOOT & ANKLE INSTITUTE OF THE CAROLINAS, 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:
Provider Other Organization Name Type Code:
6
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:
1891944195
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3301 SUNSET AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKY MOUNT
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27804-3521
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-443-7114
Provider Business Mailing Address Fax Number:
252-443-7115

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3301 SUNSET AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKY MOUNT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27804-3521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-443-7114
Provider Business Practice Location Address Fax Number:
252-443-7115
Provider Enumeration Date:
09/11/2008

Additional Information

Authorized Official

Authorized Official Last Name:
WARREN
Authorized Official First Name:
BEVERLY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
252-443-7114

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , 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: 6856119 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8908144 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 394110 . This is a "PHCS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 020NK . This is a "BCBS OF NC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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