| Kinston Community Health Center, Inc | |
|
324 N Queen Street Kinston NC 28501-4932 | |
| (252) 522-9800 | |
| (252) 523-9790 |
| Full Name | Kinston Community Health Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 324 N Queen Street, Kinston, North Carolina |
| Authorized Official Name and Position | Suzanne Freeman (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2525229800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kinston Community Health Center, Inc Po Box 2278 Kinston NC 28502-2278 Ph: (252) 522-9800 | Kinston Community Health Center, Inc 324 N Queen Street Kinston NC 28501-4932 Ph: (252) 522-9800 |
| NPI Number | 1104859313 |
|---|---|
| Provider Enumeration Date | 07/09/2006 |
| Last Update Date | 12/13/2023 |
| Medicare PECOS PAC ID | 1254318397 |
|---|---|
| Medicare Enrollment ID | O20040706001352 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104859313 | NPI | - | NPPES |
| 344575 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Dawn Quashie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790771582 PECOS PAC ID: 0648177592 Enrollment ID: I20040123000996 |
| Provider Name | Rickie Wade Ellis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831129220 PECOS PAC ID: 8325021553 Enrollment ID: I20040609001097 |
| Provider Name | Aqilah Talib Battle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972550325 PECOS PAC ID: 7012981053 Enrollment ID: I20040824001408 |
| Provider Name | Pradeep S Arumugham |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861495095 PECOS PAC ID: 3173580578 Enrollment ID: I20041217000133 |
| Provider Name | Teresa T Birchard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952360992 PECOS PAC ID: 9931097961 Enrollment ID: I20050916000339 |
| Provider Name | Ricardo L Valdivia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841257797 PECOS PAC ID: 9537165550 Enrollment ID: I20061016000383 |
| Provider Name | Julius Q Mallette |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1700879699 PECOS PAC ID: 5597761361 Enrollment ID: I20061018000565 |
| Provider Name | Steven H Berliner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487628285 PECOS PAC ID: 0648374470 Enrollment ID: I20070403000533 |
| Provider Name | Hans L Crumpler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659338473 PECOS PAC ID: 9638259500 Enrollment ID: I20080506000240 |
| Provider Name | Marion E Wright |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699986364 PECOS PAC ID: 7113096504 Enrollment ID: I20080527000818 |
| Provider Name | Lashawn Antoinette Weaver Lee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093908311 PECOS PAC ID: 3779650593 Enrollment ID: I20080923000250 |
| Provider Name | Jermaine A Joefield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164505400 PECOS PAC ID: 9133283583 Enrollment ID: I20090129000237 |
| Provider Name | Anthony G Patriarco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194799973 PECOS PAC ID: 2860455094 Enrollment ID: I20090629000543 |
| Provider Name | Michael B King |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063499861 PECOS PAC ID: 4284715228 Enrollment ID: I20100512001054 |
| Provider Name | Sarah A Byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447415351 PECOS PAC ID: 9234203522 Enrollment ID: I20100830001072 |
| Provider Name | Bushra Wasil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700092608 PECOS PAC ID: 5395991913 Enrollment ID: I20120813000852 |
| Provider Name | Jessica F Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801143177 PECOS PAC ID: 2668610361 Enrollment ID: I20130606000860 |
| Provider Name | Michael Simpson Diamond |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710144290 PECOS PAC ID: 9234378639 Enrollment ID: I20130614000626 |
| Provider Name | William Johaven Pierre Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245532118 PECOS PAC ID: 1254650575 Enrollment ID: I20150507000708 |
| Provider Name | Rekita Tashe' Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851774020 PECOS PAC ID: 1951619972 Enrollment ID: I20150924001749 |
| Provider Name | Tammy Hardison Song |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437574399 PECOS PAC ID: 7810294782 Enrollment ID: I20160322000359 |
| Provider Name | Ava D. Hudson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780801282 PECOS PAC ID: 2668656323 Enrollment ID: I20160513001416 |
| Provider Name | Cathy-anne Maria Charles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790120822 PECOS PAC ID: 7911297585 Enrollment ID: I20161004001030 |
| Provider Name | Elizabeth Colclough Coats |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932639598 PECOS PAC ID: 3971873084 Enrollment ID: I20170724000927 |
| Provider Name | Kushatha Yamaodimo Lee West-quire |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962618199 PECOS PAC ID: 5890984520 Enrollment ID: I20170828000048 |
| Provider Name | Irene Pastis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508123795 PECOS PAC ID: 2769773951 Enrollment ID: I20170912002053 |
| Provider Name | Sandy Blizzard Tripp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790073096 PECOS PAC ID: 3870850019 Enrollment ID: I20171127001502 |
| Provider Name | Robert Anthony |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598892309 PECOS PAC ID: 8123018967 Enrollment ID: I20180202000608 |
| Provider Name | Michael E Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346753522 PECOS PAC ID: 7315209749 Enrollment ID: I20180324000156 |
| Provider Name | Ashley Jones Faulkner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548769110 PECOS PAC ID: 5193087351 Enrollment ID: I20180328000428 |
| Provider Name | Hloy Tenora Green |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437444155 PECOS PAC ID: 2466617725 Enrollment ID: I20180829001283 |
| Provider Name | Lakasha Akisha Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386111722 PECOS PAC ID: 1850635830 Enrollment ID: I20181203000024 |
| Provider Name | Martin Dufour |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578792800 PECOS PAC ID: 3274662887 Enrollment ID: I20190308002659 |
| Provider Name | Charity B Sellers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184183907 PECOS PAC ID: 4385987858 Enrollment ID: I20190524000725 |
| Provider Name | Sean G Davis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881856102 PECOS PAC ID: 2668537770 Enrollment ID: I20190925004042 |
| Provider Name | Tambetta N Ojong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881041176 PECOS PAC ID: 5890027619 Enrollment ID: I20191029001081 |
| Provider Name | Ashley Laurel Self |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518314269 PECOS PAC ID: 0547553042 Enrollment ID: I20191106001897 |
| Provider Name | Alicia Jenette Whitfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649486564 PECOS PAC ID: 9638503428 Enrollment ID: I20200103000768 |
| Provider Name | Carlos Enrique Jimenez Pozo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215579602 PECOS PAC ID: 7416388996 Enrollment ID: I20200518001175 |
| Provider Name | Greene Donald Royster |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518189885 PECOS PAC ID: 2365863974 Enrollment ID: I20200608002476 |
| Provider Name | Michael Paul Byrne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881622801 PECOS PAC ID: 6507840956 Enrollment ID: I20200610001808 |
| Provider Name | Matthew Scott Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366944027 PECOS PAC ID: 8527321025 Enrollment ID: I20200617003382 |
| Provider Name | George C Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093280927 PECOS PAC ID: 9234551169 Enrollment ID: I20200623002708 |
| Provider Name | Phoebe Gisele Griffin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629315791 PECOS PAC ID: 9032417159 Enrollment ID: I20200928001285 |
| Provider Name | Tanika Michele Pinn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053430462 PECOS PAC ID: 1456480433 Enrollment ID: I20210401000725 |
| Provider Name | Daniel J Ceglowski |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1972538106 PECOS PAC ID: 2961479480 Enrollment ID: I20210714000439 |
| Provider Name | Brette Whitney Daniels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821622382 PECOS PAC ID: 1951729805 Enrollment ID: I20220125002656 |
| Provider Name | Donna Sue Dossett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629190806 PECOS PAC ID: 2264474337 Enrollment ID: I20220617000327 |
| Provider Name | Frankie Jones Letchworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417617168 PECOS PAC ID: 1052780293 Enrollment ID: I20221212000609 |
| Provider Name | Regi Jose Vadassery |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275562035 PECOS PAC ID: 3971975251 Enrollment ID: I20230215000217 |
| Provider Name | Victor U Agbai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295441202 PECOS PAC ID: 8123483484 Enrollment ID: I20230420002588 |
| Provider Name | Maryna Borodulina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518659713 PECOS PAC ID: 1153765979 Enrollment ID: I20240221000011 |
| Provider Name | Dana Lo Don Rouse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538873229 PECOS PAC ID: 9032558531 Enrollment ID: I20240417000451 |
Unc Health Complete Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Airport Rd, Kinston, NC 28501 Phone: 252-527-4146 | |
Lenoir County Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 N Mclewean St, Kinston, NC 28501 Phone: 252-526-4200 | |
Unc Health Complete Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 Doctors Dr Ste E1, Kinston, NC 28501 Phone: 252-775-5930 | |
Kinston Medical Specialists Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 Doctors Dr, Ste N, Kinston, NC 28501 Phone: 252-559-2200 Fax: 252-522-5662 | |
Kinston Internal Medicine & Geriatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2508 N Queen St, Kinston, NC 28501 Phone: 252-208-1965 Fax: 252-208-1962 | |
Physicians East, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 744 Airport Rd, Kinston, NC 28504 Phone: 252-523-0026 Fax: 252-523-1855 |