OUR CHILDREN'S CLINIC, PA (NPI# 1124135603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124135603 |
| Entity Type | Organization |
| Organization Name | OUR CHILDREN'S CLINIC, PA |
| Practice Address |
4024a Old Tar Rd Winterville NC 28590-8430 |
| Practice Telephone | 2523553773 |
| Practice Fax Number | 2523551958 |
| Mailing Telephone | 2523553773 |
| Mailing Fax Number | 2523551958 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ANGELA G. STEWART (PRESIDENT) |
| Authorized Official Telephone | 2523553773 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 890264E | 05 | |
| NC | BCBS OF NC | 0264E | 01 |
| Street Address |
4024A OLD TAR RD |
| City | WINTERVILLE |
| State | NC |
| Zip Code | 28590-8430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831127877 | Louise Bradshaw | Pediatrics | 4024a Old Tar Rd, Winterville, NC 28590-8430 | 2006-06-29 |
| 1528524782 | Marybeth Christine Rudy | Physician Assistant | 4024a Old Tar Rd, Winterville, NC 28590-8430 | 2019-02-13 |
| 1003034745 | Joseph P Byrne | Physician Assistant | 4024a Old Tar Rd, Winterville, NC 28590-8430 | 2007-04-20 |
| 1508894551 | Angela Stewart | Pediatrics | 4024a Old Tar Rd, Winterville, NC 28590-8430 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427666130 | Domika Dunn | Non-emergency Medical Transport (VAN) | 2634 Mill Street, #3, Winterville, NC 28590 | 2020-07-20 |
| 1417490194 | Sarah Blakely | Counselor | 367 Branchwood Drive, Winterville, NC 28590 | 2016-11-29 |
| 1740671817 | Faith Lewis Hardison | Social Worker | 173 A Emily Dr., Winterville, NC 28590 | 2015-02-11 |
| 1255740932 | Kendal Williams Strickland | Pharmacist | 4240 Nc Hwy 11 South, Winterville, NC 28590 | 2014-08-07 |
| 1396152757 | Patricia Ragin | Counselor | 1200 Freeland Lane, Unit K1, Winterville, NC 28590 | 2014-07-17 |
| 1780941104 | Triniti House of Restoration | Psychiatric Residential Treatment Facility | 485 Marlboro Drive, Winterville, NC 28590 | 2012-04-23 |
| 1295003002 | Linda Peer Fleming | Psychologist | 108-d West Firetower Rd., Teacch South Hall Professional Center, Winterville, NC 28590 | 2011-12-07 |
| 1740595859 | Christina Neverte Sidrak | Pharmacist | 4211 Nc Highway 11 South, Winterville, NC 28590 | 2010-08-12 |
| 1902124993 | Dove United Counseling and Assessment Services | Counselor | 575 S. Square Drive, Apt 98, Winterville, NC 28590 | 2010-05-14 |
| 1841526407 | Kyle Dombach | Pharmacist | 4211 Winterville Parkway, Winterville, NC 28590 | 2009-11-02 |
| Find all providers in zip 28590 | ||||
| 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 |
|---|---|---|---|---|
| 1831127877 | Louise Bradshaw | Pediatrics | 4024a Old Tar Rd, Winterville, NC 28590-8430 | 2006-06-29 |
| 1508894551 | Angela Stewart | Pediatrics | 4024a Old Tar Rd, Winterville, NC 28590-8430 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627146 | Kidzcare Pediatrics, PC | Pediatrics | Kidzcare Pediatrics, PC, 312 South Mccaskey Road, Williamston, NC 27892-2150 | 2020-10-21 |
| 1619582343 | Carolinas Physicians Network Inc | Pediatrics | 9908 Couloak Dr Ste 103, Charlotte, NC 28216-8678 | 2020-09-10 |
| 1992310627 | Carolinas Physicians Network Inc | Pediatrics | 1585 Forney Creek Pkwy Ste 2100, Denver, NC 28037-9520 | 2020-09-10 |
| 1861004426 | Carolinas Physicians Network Inc | Pediatrics | 4501 Cameron Valley Pkwy Ste 200-b, Charlotte, NC 28211-4297 | 2020-08-17 |
| 1871114470 | Kidzcare Pediatrics, PC | Pediatrics | 327 W College Ave, Shelby, NC 28152-8111 | 2020-05-05 |
| 1568082212 | Kidzcare Pediatrics, PC | Pediatrics | 416 Mccullough Dr Ste 140, Charlotte, NC 28262-4390 | 2020-04-23 |
| 1881222404 | Victoria Marie Carvajal | Pediatrics | Cmc/levine's Children's Hospital 1000 Blythe Blvd, 4th Floor, Meb, Charlotte, NC 28203-8812 | 2020-03-30 |
| 1386271930 | Irina Maria Geiculescu | Pediatrics | 1000 Blythe Blvd Fl 4 Meb, Charlotte, NC 28203 | 2020-03-24 |
| 1689201568 | Mark Selna | Pediatrics | 13 Weybridge Pl, Chapel Hill, NC 27517-8938 | 2020-03-23 |
| 1407488349 | Beth A Scisciani | Pediatrics | 8654 Walsham Dr, Charlotte, NC 28277-1850 | 2020-02-09 |
| Find all providers with the same taxonomy | ||||
| City | WINTERVILLE |
| Zip Code | 28590 |
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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.