EASTERN HEADACHE AND SPINE PA NPI 1952531642

NPI Information

NPI: 1952531642
Provider Name: EASTERN HEADACHE AND SPINE, PA
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

CLIA Number: 34D2013347

Address:
498 A RED BANKS ROAD
GREENVILLE, NC
ZIP 27858
Phone: (252) 215-3067
Get Directions

EASTERN HEADACHE AND SPINE, PA is a neurology psychiatry neurology in Greenville, NC. The provider is 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. EASTERN HEADACHE AND SPINE, PA NPI is 1952531642. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

498 A RED BANKS ROAD
GREENVILLE, NC
ZIP 27858
Phone: (252) 215-3067

The provider's authorized official is James Bryan Cooper .
The authorized official title is Owner and has the following contact phone number (252) 215-3067.

The CLIA number assigned to this NPI record is 34D2013347 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/16/2009 and was last updated on 3/11/2010.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P2900X	Psychiatry & Neurology	Pain Medicine	200400320	NORTH CAROLINA	No
2	2085N0700X	Radiology	Neuroradiology	200400320	NORTH CAROLINA	No
3	2084N0400X	Psychiatry & Neurology	Neurology	200400320	NORTH CAROLINA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	891363X	MEDICAID	NORTH CAROLINA
2	2027850B	MEDICARE PIN
3	1363X	OTHER		BLUE CROSS BLUE SHIELD

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

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