| Atlantic Medical Group | |
|
4 Josh Court Jacksonville NC 28546-5253 | |
| (910) 577-3636 | |
| Not Available |
| Full Name | Atlantic Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 4 Josh Court, Jacksonville, North Carolina |
| Authorized Official Name and Position | Ikechukwu Eric Ibegbu (OWNER/PROVIDER) |
| Authorized Official Contact | 9105773636 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlantic Medical Group 4 Josh Court Jacksonville NC 28546-5253 Ph: (910) 577-3636 | Atlantic Medical Group 4 Josh Court Jacksonville NC 28546-5253 Ph: (910) 577-3636 |
| NPI Number | 1962728394 |
|---|---|
| Provider Enumeration Date | 04/09/2010 |
| Last Update Date | 03/03/2017 |
| Medicare PECOS PAC ID | 4789713108 |
|---|---|
| Medicare Enrollment ID | O20100524000662 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962728394 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 200401229 (North Carolina) | Primary |
| Provider Name | Thomas F Dawson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811912884 PECOS PAC ID: 0446244404 Enrollment ID: I20040413000134 |
| Provider Name | Ikechukwu E Ibegbu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1639154248 PECOS PAC ID: 6002858099 Enrollment ID: I20050601000077 |
| Provider Name | Michael Lawrence Holloway |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427054089 PECOS PAC ID: 6507849627 Enrollment ID: I20050831000952 |
| Provider Name | Kimberly S Wiest |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194911412 PECOS PAC ID: 5294822979 Enrollment ID: I20071026000588 |
| Provider Name | Angela P Williams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477889442 PECOS PAC ID: 0648318675 Enrollment ID: I20091112000358 |
| Provider Name | Jamie H Richards |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285957209 PECOS PAC ID: 0547395188 Enrollment ID: I20100320000282 |
| Provider Name | Craig H Steffee |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1548254527 PECOS PAC ID: 7911030929 Enrollment ID: I20100728000165 |
| Provider Name | Mary Newcomb |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487898821 PECOS PAC ID: 8729139415 Enrollment ID: I20120209000285 |
| Provider Name | Jeffrey W Ashby |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396793519 PECOS PAC ID: 6507873635 Enrollment ID: I20120604000033 |
| Provider Name | James W Horvath |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1568678530 PECOS PAC ID: 8123287067 Enrollment ID: I20120606000029 |
| Provider Name | Erika Melissa Blackwell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1932511037 PECOS PAC ID: 1052530706 Enrollment ID: I20140911002218 |
| Provider Name | Mohammad Ali Esmadi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215211032 PECOS PAC ID: 3779710744 Enrollment ID: I20161007000841 |
| Provider Name | Danielle Tamara Hoo Fatt |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1083031546 PECOS PAC ID: 9739311218 Enrollment ID: I20200910000826 |
| Provider Name | Alberta Nortey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932721776 PECOS PAC ID: 1355759044 Enrollment ID: I20211019002031 |
| Provider Name | Mary-jane Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285096032 PECOS PAC ID: 8123313871 Enrollment ID: I20211117000224 |
| Provider Name | Jennifer Rodriguez-bosque |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1235605759 PECOS PAC ID: 9436521176 Enrollment ID: I20230207001478 |
| Provider Name | Yolanda Evette Sloan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235899774 PECOS PAC ID: 8022479534 Enrollment ID: I20230801000420 |
| Provider Name | Chasity Pappas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639937253 PECOS PAC ID: 3173960085 Enrollment ID: I20240326004394 |
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