Provider Type Icon

EASTERN PEDIATRICS P.A. NPI 1811024979


NPI Information

NPI: 1811024979
Provider Name: EASTERN PEDIATRICS, P.A.
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 34D1044743

Address:
1901 STONEHENGE DR
GREENVILLE, NC
ZIP 27858
Phone: (252) 561-7777
Get Directions

EASTERN PEDIATRICS, P.A. is a pediatrics in Greenville, NC. The provider is 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. EASTERN PEDIATRICS, P.A. NPI is 1811024979. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1901 STONEHENGE DR
GREENVILLE, NC
ZIP 27858-067
Phone: (252) 561-7777
Fax: (252) 561-7778

The provider's authorized official is Yoicha G Ray .
The authorized official title is Administrative/financial Supervisor and has the following contact phone number (252) 561-7777.

The CLIA number assigned to this NPI record is 34D1044743 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/27/2007 and was last updated on 10/9/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics970062NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15950204MEDICAIDNORTH CAROLINA
22348101OTHERNORTH CAROLINAMEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.