ECU PHYSICIANS MED-PEDS CLINIC (NPI# 1023423274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023423274 |
| Entity Type | Organization |
| Organization Name | ECU PHYSICIANS MED-PEDS CLINIC |
| Practice Address |
521 Moye Blvd Greenville NC 27834-2849 |
| Mailing Address |
Po Box 751069 Charlotte NC 28275-1069 |
| Practice Telephone | 2527440766 |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2020-11-04 |
| Authorized Official Name | DR. JASON A FOLTZ (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2527441882 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Street Address |
521 MOYE BLVD |
| City | GREENVILLE |
| State | NC |
| Zip Code | 27834-2849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912901653 | Robert A. Shaw | Internal Medicine | 521 Moye Blvd, Ecu Physicians Pulmonary and Critical Care, Greenville, NC 27834-2849 | 2005-06-10 |
| 1952838021 | Samantha Michele Thomas Nadler | Internal Medicine | 521 Moye Blvd, Greenville, NC 27834-2849 | 2017-05-19 |
| 1407383649 | Sara Cowles | Internal Medicine | 521 Moye Blvd, Greenville, NC 27834-2849 | 2017-05-18 |
| 1073040218 | Thomas Francis Blair | Internal Medicine | 521 Moye Blvd, Greenville, NC 27834-2849 | 2017-05-18 |
| 1528410255 | Rajarajan Panneerselvan | Internal Medicine | 521 Moye Blvd, Greenville, NC 27834-2849 | 2016-07-06 |
| 1306294004 | Michael Blaj | Student in an Organized Health Care Education/Training Program | 521 Moye Blvd, Greenville, NC 27834 | 2016-06-03 |
| 1831553346 | Steven Allen | Internal Medicine | 521 Moye Blvd, Greenville, NC 27834-2849 | 2016-04-11 |
| 1164801098 | Jackie Smalls | Internal Medicine | 521 Moye Blvd, Greenville, NC 27834 | 2015-05-26 |
| 1912386830 | Puneet Pal Singh | Internal Medicine | 521 Moye Blvd, Greenville, NC 27834-2849 | 2015-05-26 |
| 1063891901 | Deebah Ashraf Uddin | Internal Medicine | 521 Moye Blvd, Greenville, NC 27834-2849 | 2015-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801255 | Nicholas Mcarthur Bennett | Day Training, Developmentally Disabled Services | 302 C, Greenville, NC 27834 | 2020-08-11 |
| 1275150245 | Shelby Renee Jones | Student in an Organized Health Care Education/Training Program | East Carolina University College of Nursing, 600 Moye Blvd, Greenville, NC 27834 | 2020-06-25 |
| 1194347138 | Soban Ahmad | Student in an Organized Health Care Education/Training Program | 600 Moye Blvd., Vmc Ma Room 350. Internal Medicine Resi, Mailstop #734, Greenville, NC 27834 | 2020-05-13 |
| 1427687789 | Brandon Allen Yates | Student in an Organized Health Care Education/Training Program | 435 Clinic Drive, Greenville, NC 27834 | 2020-04-07 |
| 1144854407 | Kristen Springer Dreyfus | Marriage & Family Therapist | 2609 West Arlington Blvd Suite 106, Greenville, NC 27834 | 2020-02-26 |
| 1861038606 | Southern Surgical Outpatient Surgery Center, Pa | Clinic/Center | 2457 Emerald Place, Greenville, NC 27834 | 2019-11-26 |
| 1003460569 | Shaun Fitzpatrick | Nurse Practitioner | Physicians East, Pa 1850 W. Arlington Blvd., Greenville, NC 27834 | 2019-08-01 |
| 1649831496 | Katherine Salome Ross | Genetic Counselor, MS | 524 Moye Blvd, Greenville, NC 27834 | 2019-06-24 |
| 1477011880 | Lauren Bethune Scroggs | Counselor | 2150 West 5th Street, Health Sciences Building Mailstop 688, Greenville, NC 27834 | 2019-03-05 |
| 1669998001 | Idella's Care Home | Community/Behavioral Health | 2912 Lee Ct # 9a, Greenville, NC 27834 | 2017-08-17 |
| Find all providers in zip 27834 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609380278 | Sarah Rider Grubbs | Pediatrics | 58 Park Vista Way, Greenville, SC 29617-7939 | 2017-11-18 |
| 1679005409 | Shailesh Manandhar | Pediatrics | 2816 Holly Glen Dr Apt A, Greenville, NC 27834-0064 | 2017-03-30 |
| 1114377645 | Madison Leigh Merritt | Pediatrics | 415 Duncan Chapel Rd, Greenville, SC 29617-8224 | 2016-06-15 |
| 1699139089 | Hunter Utkov Altman | Pediatrics | 701 Grove Road/ob Residency, Greenville, SC 29605-4210 | 2016-04-11 |
| 1851771976 | Ranjith Kasanagottu | Pediatrics | 200 Patewood Dr # A, Greenville, SC 29615-3593 | 2015-06-03 |
| 1336551365 | Sarah Rose Mangum Needham | Pediatrics | 709 Chesapeake Pl, Greenville, NC 27858-6236 | 2014-05-26 |
| 1124466164 | Katherine Marie Richardson | Pediatrics | 200 Patewood Drive Suite A200, Greenville, SC 29615-3580 | 2013-06-12 |
| 1689916264 | Shannon Nicole James | Pediatrics | 703 Verdae Blvd, Greenville, SC 29607 | 2013-03-21 |
| 1346411592 | Smithfield Pediatrics | Pediatrics | 7 Smith Avenue, Suite 103, Greenville, RI 02828 | 2008-03-16 |
| 1558546366 | Childrens Community Care | Pediatrics | 90 Shenango St Ste 12, Greenville, PA 16125-2060 | 2007-12-31 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 27834 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.