MID ATLANTIC NEUROLOGY & SLEEP MEDICINE, P.A. (NPI# 1669708665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669708665 |
| Entity Type | Organization |
| Organization Name | MID ATLANTIC NEUROLOGY & SLEEP MEDICINE, P.A. |
| Practice Address |
227 Memorial Dr Jacksonville NC 28546-6333 |
| Mailing Address |
Po Box 12067 New Bern NC 28561-2067 |
| Practice Telephone | 9103533624 |
| Practice Fax Number | 9103530050 |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2009-10-26 |
| Authorized Official Name | KHALED F JREISAT (PRESIDENT) |
| Authorized Official Telephone | 2524743863 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | MID ATLANTIC NEUROLOGY & SLEEP MEDICINE, P.A. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043545056 | Mid Atlantic Neurology & Sleep Medicine, P.a. | Internal Medicine | 34 Office Park Dr Ste 100, Jacksonville, NC 28546-3221 | 2009-10-08 |
| Street Address |
227 MEMORIAL DR |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-6333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841739141 | Kyle Vaughn | Physician Assistant | 227 Memorial Dr, Jacksonville, NC 28546-6333 | 2017-02-20 |
| 1770672560 | Milagros Palad Cailing | Internal Medicine | 227 Memorial Dr, Jacksonville, NC 28546-6333 | 2006-10-12 |
| 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 | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285138495 | Yulia Salamatova | Psychiatry & Neurology | 580 W 8th St # T17, Jacksonville, FL 32209-6533 | 2018-03-21 |
| 1619471018 | William Joseph Scharpf | Psychiatry & Neurology | 653-1 West 8th Street, L18, 4th Floor, Lrc, Jacksonville, FL 32209 | 2018-03-20 |
| 1184155616 | Kyle Wuthrich | Psychiatry & Neurology | 580 W 8th St Fl 9, Jacksonville, FL 32209-6533 | 2017-03-26 |
| 1932511235 | Shannon Laboy | Psychiatry & Neurology | 580 W 8th St # T1-9t17, Jacksonville, FL 32209-6533 | 2014-05-21 |
| 1174933147 | Caitlin E D'souza | Psychiatry & Neurology | 14540 Old Saint Augustine Rd Ste 216, Jacksonville, FL 32258-7418 | 2014-04-30 |
| 1235416322 | Benjamin E Moore Md Pa | Psychiatry & Neurology | 2 Shircliff Way Ste 925, Jacksonville, FL 32204-4711 | 2011-11-03 |
| 1598995599 | Baptist Neurology Inc | Psychiatry & Neurology | 3563 Phillips Hwy Ste 106a, Jacksonville, FL 32207-5663 | 2009-07-24 |
| 1316104722 | Candice Waked Riggeal | Psychiatry & Neurology | 841 Prudential Dr 10th Floor, Jacksonville, FL 32207-8329 | 2008-05-22 |
| 1508089194 | James Gordon Creveling Jr | Psychiatry & Neurology | 7842 Monterey Bay Dr, Jacksonville, FL 32256-2936 | 2007-04-11 |
| 1053471987 | Mark K Emas | Psychiatry & Neurology | 4085 University Blvd South, # 3, Jacksonville, FL 32216 | 2006-12-11 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
Please comment or provide details below to improve the information on MID ATLANTIC NEUROLOGY & SLEEP MEDICINE, P.A..
| 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.