Jose Gerardo Vergara (NPI# 1194796920, PAC ID# 3476708942) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1194796920 |
| PAC ID by PECOS | 3476708942 |
| Professional Enrollment ID | I20180119000367 |
| Full Name | Jose Gerardo Vergara |
| Organization Legal Name | BLADEN HEALTHCARE LLC |
| Address |
16 3rd St Dublin NC 28332-8903 |
| Phone Number | 9108623528 |
| Gender | M |
| Graduation Year | 1989 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 6800967969 |
| Number of Group Practice Members | 53 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 341315 | CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL |
| 340028 | CAPE FEAR VALLEY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 16 3rd St, Dublin, NC 28332-8903 | 9108623528 | BLADEN HEALTHCARE LLC |
| 107 E Dunham St, Elizabethtown, NC 28337-4300 | 9108622122 | BLADEN HEALTHCARE LLC |
| Organization Legal Name | BLADEN HEALTHCARE LLC |
| Physicians | 25 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley Billups Marlowe | Nurse Practitioner | Bladen Healthcare LLC | 300 Ae Mckay St, Elizabethtown, NC 28337-9037 |
| Bryan K Monroe | Nurse Practitioner | Bladen Healthcare LLC | 107 E Dunham St, Elizabethtown, NC 28337-4300 |
| Shelley Brown | Nurse Practitioner | Bladen Healthcare LLC | 1106 W Seaboard St, Bladenboro, NC 28320-6985 |
| Shakonda L Strayhorn | Obstetrics/gynecology | Bladen Healthcare LLC | 300 Mckoy St, Elizabethtown, NC 28337-9011 |
| Ronald Wade Cottle | Family Medicine | Bladen Healthcare LLC | 88 E Green St, Clarkton, NC 28433-5003 |
| Briana G Graham | Physician Assistant | Bladen Healthcare LLC | 501 S Poplar St, Elizabethtown, NC 28337-9375 |
| Robert L Rich Jr. | Family Medicine | Bladen Healthcare LLC | 300 Ae Mckay St, Elizabethtown, NC 28337-9037 |
| Larry J Yoder | Certified Registered Nurse Anesthetist (crna) | Bladen Healthcare LLC | 501 S Poplar St, Elizabethtown, NC 28337-9375 |
| Pearly Graham-hoskins | Internal Medicine | Bladen Healthcare LLC | 501 S Poplar St, Elizabethtown, NC 28337-9375 |
| Crystal R Newton | Nurse Practitioner | Bladen Healthcare LLC | 16 3rd St, Dublin, NC 28332-8903 |
| Street Address |
16 3RD ST |
| City | DUBLIN |
| State | NC |
| Zip | 28332-8903 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Crystal R Newton | Nurse Practitioner | Bladen Healthcare LLC | 16 3rd St, Dublin, NC 28332-8903 |
| Jennifer R Smith | Nurse Practitioner | Bladen Healthcare LLC | 16 3rd St, Dublin, NC 28332-8903 |
| Robyn D Goostree | Nurse Practitioner | Bladen Healthcare LLC | 16 3rd St, Dublin, NC 28332-8903 |
| City | DUBLIN |
| Zip Code | 28332 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | DUBLIN + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Jose Gerardo Vergara.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.