Colerain Primary Care | |
109 W River St Colerain NC 27924-9006 | |
(252) 356-2404 | |
(252) 356-2899 |
Full Name | Colerain Primary Care |
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Speciality | Clinic/Center |
Location | 109 W River St, Colerain, North Carolina |
Authorized Official Name and Position | Stephanie Wroten (INTERIM - CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 2523323548 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Colerain Primary Care Po Box 669 Ahoskie NC 27910-0669 Ph: (252) 209-0237 | Colerain Primary Care 109 W River St Colerain NC 27924-9006 Ph: (252) 356-2404 |
NPI Number | 1790851004 |
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Provider Enumeration Date | 11/28/2006 |
Last Update Date | 03/28/2024 |
Medicare PECOS PAC ID | 7214983386 |
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Medicare Enrollment ID | O20050428001071 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790851004 | NPI | - | NPPES |
018N8 | Other | NC | BCBSNC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | John R Pickett |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1629134127 PECOS PAC ID: 4789586975 Enrollment ID: I20040127000551 |
Provider Name | Michael C Alston |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1326067224 PECOS PAC ID: 0345235032 Enrollment ID: I20040420001154 |
Provider Name | Catherine S Brown |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730172818 PECOS PAC ID: 8527020296 Enrollment ID: I20041103001321 |
Provider Name | Vijay R Dhoopati |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1619919230 PECOS PAC ID: 0446147904 Enrollment ID: I20050112000332 |
Provider Name | Charles J Sawyer |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1902842156 PECOS PAC ID: 6709825680 Enrollment ID: I20050429000450 |
Provider Name | Colin D Jones |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1891722807 PECOS PAC ID: 5597704478 Enrollment ID: I20050429000467 |
Provider Name | Julian R Taylor |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1346277357 PECOS PAC ID: 9931148822 Enrollment ID: I20050429000488 |
Provider Name | Christina G Griffiths |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609895580 PECOS PAC ID: 4385683283 Enrollment ID: I20050429000579 |
Provider Name | Michelle W Lewis |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1922172238 PECOS PAC ID: 6507800232 Enrollment ID: I20050614000781 |
Provider Name | Gilberto Pabalan Navarro |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1518945385 PECOS PAC ID: 7315979077 Enrollment ID: I20050909000411 |
Provider Name | Emmie L Taylor |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1114064045 PECOS PAC ID: 5294754826 Enrollment ID: I20051114000396 |
Provider Name | Robert L Venable |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1750336855 PECOS PAC ID: 1052340544 Enrollment ID: I20060214000287 |
Provider Name | Kathryn Lesiewicz |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831182724 PECOS PAC ID: 1254319973 Enrollment ID: I20081202000595 |
Provider Name | Timothy J. Mcgrath |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1528085552 PECOS PAC ID: 4385778729 Enrollment ID: I20100819001240 |
Provider Name | Jamande Amin Jones |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1003136383 PECOS PAC ID: 5799910733 Enrollment ID: I20131030000130 |
Provider Name | Geniene Nicole Jones |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1568782845 PECOS PAC ID: 4284861527 Enrollment ID: I20131212001404 |
Provider Name | Lindsey Dale Phelps-copeland |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1053749820 PECOS PAC ID: 8820225915 Enrollment ID: I20131217000914 |
Provider Name | Teresa Lanier Morris |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366815052 PECOS PAC ID: 4789985110 Enrollment ID: I20151209000780 |
Provider Name | Charlene Brown |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841774841 PECOS PAC ID: 7214276351 Enrollment ID: I20190306003549 |
Provider Name | Charles Olufemi Folashade |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1992764559 PECOS PAC ID: 1557346582 Enrollment ID: I20190819000284 |
Provider Name | Angela Miller |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194375584 PECOS PAC ID: 9436584216 Enrollment ID: I20200124002002 |
Provider Name | Aline Studstill |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972137040 PECOS PAC ID: 3678994159 Enrollment ID: I20200609002545 |
Provider Name | Karen Brixon - Holloway |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629684642 PECOS PAC ID: 1557774866 Enrollment ID: I20210106000074 |
Provider Name | Robert James Jordan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336725050 PECOS PAC ID: 3870993637 Enrollment ID: I20210616000014 |
Provider Name | Jared Carter-davis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245705748 PECOS PAC ID: 6103161989 Enrollment ID: I20211004000972 |
Provider Name | Julia Blackwell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881357028 PECOS PAC ID: 8921496365 Enrollment ID: I20211103003047 |
Provider Name | Catherine Grimes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952799496 PECOS PAC ID: 0345567020 Enrollment ID: I20220323000471 |
Provider Name | Amber Dickerson Williams |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780262311 PECOS PAC ID: 1456746627 Enrollment ID: I20220325000376 |
Provider Name | Julie Ann Mead |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205450897 PECOS PAC ID: 1153718911 Enrollment ID: I20220425002415 |
Provider Name | Mackenzie Lesha Wilson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215663737 PECOS PAC ID: 9830558188 Enrollment ID: I20230705000240 |
Provider Name | Chaquella Daughtry |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1902567928 PECOS PAC ID: 7911366612 Enrollment ID: I20231221001530 |
Provider Name | Mary Chester Morgan Wasko |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1598731945 PECOS PAC ID: 4789863077 Enrollment ID: I20240206001902 |
Provider Name | Ruthie Daniels Rowe |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1629770748 PECOS PAC ID: 2860836137 Enrollment ID: I20240215000821 |
Provider Name | Susan T Hoggard |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013079938 PECOS PAC ID: 8022458439 Enrollment ID: I20240502001872 |
Provider Name | Ursula Knight Sutton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942069943 PECOS PAC ID: 3678015880 Enrollment ID: I20240603004234 |
Provider Name | Varsha Vera Whitmore |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295369957 PECOS PAC ID: 0840620282 Enrollment ID: I20240604001816 |