BEACHCARE URGENT MEDICAL CARE CENTER OF HAVELOCK (NPI# 1083600720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083600720 |
| Entity Type | Organization |
| Organization Name | BEACHCARE URGENT MEDICAL CARE CENTER OF HAVELOCK |
| Other Organization Name | BEACHCARE OF HAVELOCK |
| Practice Address |
1224 E Main St Havelock NC 28532-2405 |
| Practice Telephone | 2524477474 |
| Practice Fax Number | 2524471050 |
| Mailing Telephone | 2524477474 |
| Mailing Fax Number | 2524471050 |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2010-11-04 |
| Authorized Official Name | MR. WILLIAM GRAHAM EVANS JR. (CLINICAL DIRECTOR/OWNER) |
| Authorized Official Telephone | 2524477474 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
39759 | NC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BLUE CROSS BLUE SHIELD | 0138B | 01 |
| NC | 344612A | 05 | |
| NC | 344612C | 05 |
| Other Name | Type Code |
|---|---|
| Beachcare of Havelock | Doing Business As Name - Organization |
| Street Address |
1224 E MAIN ST |
| City | HAVELOCK |
| State | NC |
| Zip Code | 28532-2405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952397101 | William Graham Evans Jr. | Physician Assistant | 1224 E Main St, Havelock, NC 28532-2405 | 2005-09-23 |
| 1891282638 | Coastal Carolina Health Care, Pa | Family Medicine | 1224 E Main St, Havelock, NC 28532-2405 | 2018-04-17 |
| 1245789379 | Radonna Carroll | Nurse Practitioner | 1224 E Main St, Havelock, NC 28532-2405 | 2016-09-30 |
| 1851784185 | Constance Hall | Nurse Practitioner | 1224 E Main St, Havelock, NC 28532-2405 | 2015-03-11 |
| 1194161380 | Quicker Care Clinic Pa | Emergency Medicine | 1224 E Main St, Havelock, NC 28532-2405 | 2013-05-15 |
| 1639489966 | Elizabeth Dawn Burnette | Registered Nurse | 1224 E Main St, Havelock, NC 28532-2405 | 2010-10-20 |
| 1891783056 | Jean Basnight | Family Medicine | 1224 E Main St, Havelock, NC 28532 | 2005-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194341396 | Tara-dawm R Tootle | Pharmacist | 1204 E Mail St, Havelock, NC 28532 | 2020-06-23 |
| 1194377903 | Jessy Eugene Warren Whittall | Military Health Care Provider | 4389 Beafort Rd, Havelock, NC 28532 | 2019-07-11 |
| 1508375676 | Lacey Leeann Robinson | Dentist | 610 Miller Boulevard, Havelock, NC 28532 | 2017-09-21 |
| 1053861112 | Adam Toliver Davis | Dentist | 502 Us Hwy 70 West, Havelock, NC 28532 | 2016-10-12 |
| 1467825331 | Stephany Agudelo | Social Worker | 102 Verona Dive, Havelock, NC 28532 | 2015-11-02 |
| 1386089225 | Joanna Tiaira Johnson | Nurse Practitioner | 4389 Beaufort, Havelock, NC 28532 | 2013-05-06 |
| 1962665653 | Coastal Childrens Clinic | Pediatrics | 218 Stone Bridge Square, Havelock, NC 28532 | 2008-07-03 |
| 1235325218 | Michelle Land Amber | Dietitian, Registered | 210 Stonebridge Square, Havelock, NC 28532 | 2007-09-24 |
| 1437217213 | Havelock Chiropractic Center P.a. | Chiropractor | 314 Highway 70 West, Havelock, NC 28532 | 2006-12-05 |
| 1831273127 | David Lee Woodward Jr. | Chiropractor | 314 Hwy. 70 West, Havelock, NC 28532 | 2006-10-24 |
| Find all providers in zip 28532 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689209553 | Murphy Medical Center Inc | Clinic/Center | 125 Medical Park Ln Ste H, Murphy, NC 28906-6921 | 2020-03-11 |
| 1528623725 | Cynthia Mcarthur-kearney | Clinic/Center | 531 Hillsboro St, Fayetteville, NC 28301-4634 | 2019-05-03 |
| 1528559671 | Bladen Healthcare LLC | Clinic/Center | 273 White Lake Dr, White Lake, NC 28337 | 2018-05-24 |
| 1043759335 | Bladen Healthcare LLC | Clinic/Center | 88 E Green St., Clarkton, NC 28433-5002 | 2017-02-20 |
| 1114269677 | Bladen Healthcare LLC | Clinic/Center | 107e Dunham St, Elizabethtown, NC 28337-9037 | 2013-03-22 |
| 1699062802 | Cah Acquisition Company 1 LLC | Clinic/Center | 9500 Nc Highway 94 North, Creswell, NC 27928-8808 | 2011-07-08 |
| 1912294687 | Pioneer Health Services of Stokes County, Inc. | Clinic/Center | 1020 Hospice Drive, Danbury, NC 27016-0000 | 2011-07-01 |
| 1578858247 | Warren Community Health Clinic Inc. | Clinic/Center | 546 W Ridgeway St, Warrenton, NC 27589-1716 | 2011-06-10 |
| 1427282045 | Southeastern Regional Physician Services | Clinic/Center | 2002 N Cedar St Ste B, Lumberton, NC 28358-3926 | 2009-05-11 |
| 1578702189 | Appalachian Healthcare, Inc. | Clinic/Center | 9330 Highway 194, Lansing, NC 28643-0184 | 2009-02-05 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on BEACHCARE URGENT MEDICAL CARE CENTER OF HAVELOCK.
| 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.