HEALTHEAST OUTER BANKS MEDICAL CENTER LLC (NPI# 1174585012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174585012 |
| Entity Type | Organization |
| Organization Name | HEALTHEAST OUTER BANKS MEDICAL CENTER LLC |
| Other Organization Name | HEALTHEAST FAMILY CARE-AVON |
| Practice Address |
40894 Hwy 12 Avon NC 27915 |
| Practice Telephone | 2529953073 |
| Mailing Telephone | 2529953073 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2008-06-16 |
| Authorized Official Name | MRS. LYNN T. LANIER (VP OF FINANCE FOR EAST CAROLINA HEA) |
| Authorized Official Telephone | 2528477479 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 790290R | 05 | |
| NC | BCBS PROVIDER # | 0290R | 01 |
| Other Name | Type Code |
|---|---|
| Healtheast Family Care-Avon | Doing Business As Name - Organization |
| Street Address |
40894 HWY 12 |
| City | AVON |
| State | NC |
| Zip Code | 27915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548667983 | Jennifer Anne Thor | Counselor | 41838 Nc 12, Ste 104, Avon, NC 27915 | 2014-12-01 |
| 1801940614 | Albemarle Mental Health Center | Social Worker | Sun Realty Building, Avon, NC 27915 | 2007-01-22 |
| 1114001955 | Beach Pharmacy II Ltd | Pharmacy | 41934 Hwy 12, Avon, NC 27915 | 2006-10-25 |
| 1871563817 | Thomas Bentley Crabtree, Jr. | Family Medicine | 40894 Highway 12, Avon, NC 27915 | 2006-01-24 |
| 1891826616 | Jamie L Fountain | Internal Medicine | 40894 Highway 12, Healtheast Outer Banks Medical Center, Avon, NC 27915 | 2007-03-07 |
| 1972659753 | Albemarle Mental Health Center | Clinical Neuropsychologist | Sun Realty Building, Avon, NC 27915 | 2007-01-26 |
| 1336293190 | Albemarle Mentl Health Center | Clinic/Center | Sun Realty Building, Avon, NC 27915 | 2007-01-22 |
| 1669774394 | Lonnie Timothy Morgan | Pharmacist | 41934 Hwy 12, Avon, NC 27915-0660 | 2010-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518950 | Mobile Foot Care Specialists, L.L.C. | Podiatrist | 38752 Renwood Ave, Avon, OH 44011-5229 | 2020-11-06 |
| 1417557026 | Genesis Campos | Social Worker | 35 Tower Ln Ste 202, Avon, CT 06001-4237 | 2020-11-01 |
| 1447859145 | Kristina Corn | Occupational Therapist | 856 Millbrook Dr, Avon, IN 46123-7454 | 2020-10-22 |
| 1497354310 | Smileez | Dentist | 1 Darling Dr, Avon, CT 06001-4277 | 2020-10-21 |
| 1124627575 | Heather Leigh Black | Counselor | 12 Lakeview Blvd, Avon, CT 06001-3442 | 2020-10-17 |
| 1760099956 | Jessica Thornton | Dietitian, Registered | 5919 Pine Bluff Dr, Avon, IN 46123-6681 | 2020-09-30 |
| 1093322349 | Angela M Demchuk | Home Health Aide | 2735 Center Rd, Avon, OH 44011-1838 | 2020-09-29 |
| 1740897578 | Sierra Hinds | Student in an Organized Health Care Education/Training Program | 216 Commerce Dr, Avon, NY 14414-9784 | 2020-09-25 |
| 1467069377 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 38292 Colorado Ave, Avon, OH 44011-1002 | 2020-09-24 |
| 1437764339 | Kaitlin Mishel Ragan | Behavioral Analyst | 5250 E Us Highway 36 Ste 670, Avon, IN 46123-7867 | 2020-09-09 |
| Find all providers in AVON | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093361842 | Vail Clinic, Inc. | Clinic/Center | 1280 Village Rd, Avon, CO 81620 | 2019-08-16 |
| 1295381390 | Vail Clinic, Inc. | Clinic/Center | 126 Riverfront Lane, Suite 101, Avon, CO 81620 | 2019-08-14 |
| 1851459879 | Kaiser Permanente | Clinic/Center | 1426 Center Road, Avon, OH 44011 | 2006-12-04 |
| 1295381192 | Vail Clinic, Inc. | Clinic/Center | 230 Chapel Place, Avon, CO 81620 | 2019-08-15 |
| 1851807218 | Komarow Dental PC | Clinic/Center | 40 Dale Rd, Avon, CT 06001-3692 | 2017-12-21 |
| 1093239683 | Hartford Healthcare Urgent Care Centers, LLC | Clinic/Center | 385 W Main St, Avon, CT 06001-4357 | 2017-07-26 |
| 1649791971 | Henry Wellness Services, LLC | Clinic/Center | 192 N Avon Ave Ste 300, Avon, IN 46123-9515 | 2017-06-27 |
| 1457896862 | Dobrita Family Care LLC | Clinic/Center | 46 W Avon Rd, Suite 301, Avon, CT 06001-3679 | 2016-12-21 |
| 1598208332 | Samantha Lynn Tarcy | Clinic/Center | 33100 Cleveland Clinic Blvd, Cardiology Dept - Coumadin Clinic, Avon, OH 44011-1390 | 2016-11-28 |
| 1699142133 | Centers for Hope & Wellness, Inc. | Clinic/Center | 7517 Beechwood Centre Rd, Suite 300, Avon, IN 46123-7852 | 2015-09-01 |
| Find all providers in AVON | ||||
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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.