BLADEN HEALTHCARE, LLC (NPI# 1700052289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700052289 |
| Entity Type | Organization |
| Organization Name | BLADEN HEALTHCARE, LLC |
| Other Organization Name | CAPE FEAR VALLEY - BLADEN SURGICAL SPECIALISTS |
| Practice Address |
300a E Mckay St Elizabethtown NC 28337-9037 |
| Mailing Address |
501 S Poplar St Elizabethtown NC 28337-9375 |
| Practice Telephone | 9108621274 |
| Practice Fax Number | 9108625129 |
| Mailing Telephone | 9108625179 |
| Mailing Fax Number | 9108625129 |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2013-09-09 |
| Authorized Official Name | MS. JESSICA LANG (DIRECTOR) |
| Authorized Official Telephone | 9108625178 |
| Is Organization Subpart | Y |
| Parent Organization Name | BLADEN HEALTHCARE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC0050X |
Clinic/Center Specialization: Critical Access Hospital |
H0154 | NC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 89015UF | 05 |
| Other Name | Type Code |
|---|---|
| Cape Fear Valley - Bladen Surgical Specialists | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417123993 | Bladen Healthcare, LLC | Clinic/Center | 1106 W Seaboard St, Bladenboro, NC 28320-6985 | 2008-05-05 |
| 1477729952 | Bladen Healthcare, LLC | Clinic/Center | 300 E Mckay Street, Elizabethtown, NC 28337 | 2008-05-05 |
| 1255507737 | Bladen Healthcare, LLC | Clinic/Center | 300-a East Mckay Street, Elizabethtown, NC 28337 | 2008-05-05 |
| 1689018756 | Bladen Healthcare, LLC | General Acute Care Hospital | 501 S Poplar St, Elizabethtown, NC 28337-9375 | 2013-04-19 |
| 1114193695 | Bladen Healthcare, LLC | Clinic/Center | 16 3rd Street, Dublin, NC 28332 | 2008-05-05 |
| 1811163397 | Bladen Healthcare, LLC | Nurse Anesthetist, Certified Registered | 501 S Poplar St, Elizabethtown, NC 28337-9375 | 2008-05-05 |
| 1205002789 | Bladen Healthcare, LLC | Clinic/Center | 501 S Poplar St, Elizabethtown, NC 28337-9375 | 2008-05-05 |
| 1841466323 | Bladen Healthcare, LLC | Clinic/Center | 501 S Poplar St, Elizabethtown, NC 28337-9375 | 2008-05-05 |
| 1750557237 | Bladen Healthcare, LLC | Clinic/Center | 501 S Poplar St, Elizabethtown, NC 28337-9375 | 2008-05-05 |
| 1669648143 | Bladen Healthcare, LLC | Family Medicine | 501 S Poplar St, Elizabethtown, NC 28337-9375 | 2008-05-05 |
| Street Address |
300A E MCKAY ST |
| City | ELIZABETHTOWN |
| State | NC |
| Zip Code | 28337-9037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578110482 | Stephanie Gooden | Physician Assistant | 300a E Mckay St, Elizabethtown, NC 28337-9037 | 2019-08-26 |
| 1881119873 | Trelena Christeen Brown | Physician Assistant | 300a E Mckay St, Elizabethtown, NC 28337 | 2017-08-10 |
| 1952756520 | Telina Hunt | Nurse Practitioner | 300a E Mckay St, Elizabethtown, NC 28337-9037 | 2016-05-02 |
| 1437449733 | Shelley Yvonne Brown | Nurse Practitioner | 300a E Mckay St, Elizabethtown, NC 28337-9037 | 2011-04-08 |
| 1982902771 | Angie Evans Lowry | Nurse Practitioner | 300a E Mckay St, Elizabethtown, NC 28337-9037 | 2011-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801439799 | John Archie Jackson Jr. | Counselor | 209 Martin Luther King Dr, Elizabethtown, NC 28337 | 2019-10-23 |
| 1649826447 | Donna Marie Gray | Technician | 1797 Mercer Mill Rd, Elizabethtown, NC 28337 | 2019-08-16 |
| 1053972877 | Professional Eye Care Optometry, Pa | Optometrist | 432 W Broad St, Elizabethtown, NC 28337 | 2019-06-24 |
| 1255896015 | Andersons Drug Store LLC | Durable Medical Equipment & Medical Supplies | 206 S. Poplar St., Elizabethtown, NC 28337 | 2019-02-06 |
| 1336618602 | Genese Anderson Peed | Pharmacist | 206 South Poplar, Elizabethtown, NC 28337 | 2018-11-16 |
| 1528559671 | Bladen Healthcare LLC | Clinic/Center | 273 White Lake Dr, White Lake, NC 28337 | 2018-05-24 |
| 1821586918 | Coastal Horizons Center Inc. | Community/Behavioral Health | Coastal Horizons Center, Inc. - Bladen Day Treatment, 1496 Hwy 701 S., Elizabethtown, NC 28337 | 2018-04-25 |
| 1205353117 | Brianna Stalnaker | Pharmacist | 371 S Poplar St, Elizabethtown, NC 28337 | 2017-08-23 |
| 1982124681 | Justin M Degarmo Dmd & Ann Hamill Greene Dds Pa | Dentist | 401 Doctors Drive, Elizabethtown, NC 28337 | 2017-06-23 |
| 1336676121 | Megan Mcwhorter | Physical Therapy Assistant | 804 South Poplar Street, Elizabethtown, NC 28337 | 2017-05-11 |
| Find all providers in zip 28337 | ||||
| Taxonomy Code | 261QC0050X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Critical Access Hospital |
| An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477729952 | Bladen Healthcare, LLC | Clinic/Center | 300 E Mckay Street, Elizabethtown, NC 28337 | 2008-05-05 |
| 1750311452 | Bladen County Hospital | Clinic/Center | 300 East Mckay Street, Suite F, Elizabethtown, NC 28337 | 2006-07-05 |
| 1114958576 | Bladen County Hospital | Clinic/Center | 103 East Dunham Street, Elizabethtown, NC 28337 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194016055 | J. Arthur Dosher Memorial Hospital | Clinic/Center | 11 E 9th St, Southport, NC 28461-3083 | 2011-04-27 |
| 1215054549 | Davie County Hospital Primary Care | Clinic/Center | 223 Hospital St, Mocksville, NC 27028-2038 | 2007-03-23 |
| City | ELIZABETHTOWN |
| Zip Code | 28337 |
Please comment or provide details below to improve the information on BLADEN HEALTHCARE, LLC.
| 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.