NORTHSIDE PARK GASTROENTEROLOGY & ENDOSCOPY CENTER PLLC (NPI# 1336422302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336422302 |
| Entity Type | Organization |
| Organization Name | NORTHSIDE PARK GASTROENTEROLOGY & ENDOSCOPY CENTER PLLC |
| Practice Address |
102 Northside Park Dr Elizabeth City NC 27909 |
| Practice Telephone | 2523354619 |
| Practice Fax Number | 2523355744 |
| Mailing Telephone | 2523354619 |
| Mailing Fax Number | 2523355744 |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2011-10-22 |
| Authorized Official Name | MICHAEL SUE (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 2523354619 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 151718 | NC | Other Service Providers |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
9600169 | NC | Allopathic & Osteopathic Physicians |
| Street Address |
102 NORTHSIDE PARK DR |
| City | ELIZABETH CITY |
| State | NC |
| Zip Code | 27909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482177 | Leslie Treherne-fayton Dds Pllc | Dentist | 3875 Conlon Way Ste A, Elizabeth City, NC 27909 | 2020-03-13 |
| 1053829077 | Kaitlyn Daniels | Counselor | 1825 West City Drive, Suites A&b, Elizabeth City, NC 27909 | 2018-01-11 |
| 1487183778 | Traniqua Mccullen | Social Worker | 314 Orchard Drive, Elizabeth City, NC 27909 | 2017-06-08 |
| 1760938401 | Lauren Noele Schaefer | Physical Therapist | 615 S Hughes Boulevard, Unit B, Elizabeth City, NC 27909 | 2016-09-01 |
| 1588023279 | Regina Mccoy | Nurse Practitioner | 1507 N Road St Ste 3, Elizabeth City, NC 27909 | 2016-02-23 |
| 1750753760 | Mark C. ''chris'' Patterson | Physician Assistant | Coast Guard Base Elizabeth City, 1664 Weeksville Road, Building 128, Elizabeth City, NC 27909 | 2015-10-29 |
| 1770963365 | Harlan Bradley Hurdle | Pharmacist | 104 Breezewood Drive, Elizabeth City, NC 27909 | 2015-06-09 |
| 1558779298 | Wilkiam Wilson | Counselor | 1290 Halstead Blvd, Elizabeth City, NC 27909 | 2014-07-25 |
| 1871919886 | Courtney Bunch | Specialist/Technologist | 1680 Cedar Point Circle, Elizabeth City, NC 27909 | 2014-03-14 |
| 1790100832 | The Power of U | Community/Behavioral Health | 1023 Us17s Suite 1, Elizabeth City, NC 27909 | 2014-02-26 |
| Find all providers in zip 27909 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346889292 | Park Gastroenterology, Pllc | Internal Medicine | 7560 Carpenter Fire Station Rd Ste 303, Cary, NC 27519-9637 | 2019-12-24 |
| 1528625399 | Rowan Endoscopy Center, Pllc | Internal Medicine | 1809 Brenner Ave, Suite 102, Salisbury, NC 28144-2558 | 2019-05-28 |
| 1073091088 | Gastroenterology Associates of The Piedmont, P.a. | Internal Medicine | 445 Pineview Dr Ste 200b, Kernersville, NC 27284 | 2018-08-01 |
| 1710489273 | Appalachian Regional Medical Associates Inc | Internal Medicine | Appgastro - Asc, 870 State Farm Rd, Ste 102, Boone, NC 28607 | 2018-03-01 |
| 1669971826 | Appalachian Regional Medical Associates Inc | Internal Medicine | 870 State Farm Rd Ste 2, Boone, NC 28607-4861 | 2018-02-02 |
| 1437556594 | Novant Medical Group Inc | Internal Medicine | 13 Medical Campus, Suite 102, Supply, NC 28462-4093 | 2014-12-04 |
| 1275930968 | Digestive Health Specialists, Pa | Internal Medicine | 434 Kirby Rd, Lower Level Suite 6, King, NC 27021-9494 | 2014-11-25 |
| 1326454174 | Daniel Dillon | Internal Medicine | 1045 25th Avenue Dr Nw, Hickory, NC 28601-9077 | 2014-07-01 |
| 1841610300 | Shelly Gurwara | Internal Medicine | Medical Ctr Blvd, Winston Salem, NC 27157-2358 | 2014-04-23 |
| 1518386457 | Silpa Yalamanchili | Internal Medicine | 781 Avent Ferry Rd Ste 204, Holly Springs, NC 27540-7776 | 2014-04-08 |
| Find all providers with the same taxonomy | ||||
| City | ELIZABETH CITY |
| Zip Code | 27909 |
Please comment or provide details below to improve the information on NORTHSIDE PARK GASTROENTEROLOGY & ENDOSCOPY CENTER PLLC.
| 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.