Black River Health Center | |
109 W Church St Atkinson NC 28421-9230 | |
(910) 283-7783 | |
(910) 283-7927 |
Full Name | Black River Health Center |
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Speciality | Clinic/Center |
Location | 109 W Church St, Atkinson, North Carolina |
Authorized Official Name and Position | Lee Ann Amann (ADMINISTRATOR) |
Authorized Official Contact | 9102596973 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Black River Health Center 301 S Campbell St Burgaw NC 28425-5011 Ph: (910) 259-6973 | Black River Health Center 109 W Church St Atkinson NC 28421-9230 Ph: (910) 283-7783 |
NPI Number | 1174511976 |
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Provider Enumeration Date | 10/06/2005 |
Last Update Date | 12/12/2019 |
Medicare PECOS PAC ID | 0345131579 |
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Medicare Enrollment ID | O20040324001267 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174511976 | NPI | - | NPPES |
343867AC | Medicaid | NC | |
03009 | Other | BCBS |
Provider Name | Melissa Ann Presley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457370546 PECOS PAC ID: 2062488695 Enrollment ID: I20070822001296 |
Provider Name | Linda I Greenspan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1528099462 PECOS PAC ID: 9436245453 Enrollment ID: I20071022000353 |
Provider Name | Alan D Ancillotti |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972845204 PECOS PAC ID: 3476505371 Enrollment ID: I20130828001033 |
Provider Name | Holly Ann Kilian |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639555493 PECOS PAC ID: 4284943663 Enrollment ID: I20151026002327 |
Provider Name | Jennifer Lynn Givens |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669871182 PECOS PAC ID: 8527385517 Enrollment ID: I20151223001478 |
Provider Name | Erika Denaci Woodfox |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982055257 PECOS PAC ID: 4688959380 Enrollment ID: I20170321000154 |
Provider Name | William Thomas Fossett |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851860183 PECOS PAC ID: 5193061083 Enrollment ID: I20190114003318 |
Provider Name | Jerrol J Robinson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851554406 PECOS PAC ID: 1355416645 Enrollment ID: I20190531001507 |
Provider Name | Sara Jean Sutton-meyer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457911075 PECOS PAC ID: 9739519414 Enrollment ID: I20200420003537 |
Provider Name | Jodie Butler Hall |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851984082 PECOS PAC ID: 7719384593 Enrollment ID: I20210921002192 |
Provider Name | Kristina Lynn Gardner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790167724 PECOS PAC ID: 7517273642 Enrollment ID: I20221123002341 |
Provider Name | Bailey Minish |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1962023176 PECOS PAC ID: 1759712011 Enrollment ID: I20230830002446 |