PSYCHIATRIC SERVICES OF EASTERN CAROLINA (NPI# 1295095438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295095438 |
| Entity Type | Organization |
| Organization Name | PSYCHIATRIC SERVICES OF EASTERN CAROLINA |
| Practice Address |
161 Mendover Dr Jacksonville NC 28546-9207 |
| Practice Telephone | 9105263288 |
| Mailing Telephone | 9105263288 |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2012-05-22 |
| Authorized Official Name | ROBERT SEIGEL (OWNER) |
| Authorized Official Telephone | 9105263288 |
| Authorized Official Credential | NURSE PRACTITION |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
207454 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
161 MENDOVER DR |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-9207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720691843 | Eralene Manangan | Nurse Practitioner | 4205 Belfort Rd Ste 4030, Jacksonville, FL 32216-1475 | 2020-08-28 |
| 1306456025 | Richard Mercer | Nurse Practitioner | 3545 Saint Johns Bluff Rd S Ste 137, Jacksonville, FL 32224-2682 | 2020-08-06 |
| 1467060434 | Rebecca Bertone | Nurse Practitioner | 8540 Turkey Oaks Dr S, Jacksonville, FL 32277-2920 | 2020-07-16 |
| 1861018616 | Octavia J Robertson | Nurse Practitioner | 3562 Boone Park Ave, Jacksonville, FL 32205-8433 | 2020-06-17 |
| 1902428568 | Kimberly J Grant | Nurse Practitioner | 8680 Baymeadows Rd E Apt 1413, Jacksonville, FL 32256-4002 | 2020-05-17 |
| 1447710900 | Shannska Atis | Nurse Practitioner | 580 W 8th St Fl II5, Jacksonville, FL 32209-6533 | 2019-03-21 |
| 1811462237 | Dzenefa Ramic | Nurse Practitioner | 10175 Fortune Pkwy Unit 206, Jacksonville, FL 32256-6748 | 2018-10-11 |
| 1851871024 | Shakhia Grant | Nurse Practitioner | 3636 University Blvd S Ste B, Jacksonville, FL 32216-4223 | 2018-08-17 |
| 1295230845 | Lacey Cawthron | Nurse Practitioner | 8130 Baymeadows Cir W Ste 109, Jacksonville, FL 32256-1837 | 2018-03-27 |
| 1083116107 | Kbn Healthcare, Pllc | Nurse Practitioner | 9471 Baymeadows Rd Ste 3, Jacksonville, FL 32256-7932 | 2018-03-05 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
Please comment or provide details below to improve the information on PSYCHIATRIC SERVICES OF EASTERN CAROLINA.
| 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.