Black River Health Services Inc - Medicare Primary Care in Atkinson, NC

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Black River Health Services Inc is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Atkinson, North Carolina. The current practice location for Black River Health Services Inc is 109 W Church St, Atkinson, North Carolina. For appointments, you can reach them via phone at (910) 283-7783. The mailing address for Black River Health Services Inc is 301 S Campbell St, Burgaw, North Carolina and phone number is (910) 259-6973.

Black River Health Services Inc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1174511976. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (910) 283-7783.

Contact Information

Black River Health Services Inc
109 W Church St
Atkinson
NC 28421-9230
(910) 283-7783
(910) 283-7927

Map and Direction


Primary Care Clinic Profile

Full NameBlack River Health Services Inc
SpecialityClinic/Center
Location109 W Church St, Atkinson, North Carolina
Authorized Official Name and PositionLee Ann Amann (ADMINISTRATOR)
Authorized Official Contact9102596973
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Black River Health Services Inc
301 S Campbell St
Burgaw
NC 28425-5011

Ph: (910) 259-6973		Black River Health Services Inc
109 W Church St
Atkinson
NC 28421-9230

Ph: (910) 283-7783

NPI Details:

NPI Number1174511976
Provider Enumeration Date10/06/2005
Last Update Date12/12/2019

Medicare PECOS Information:

Medicare PECOS PAC ID0345131579
Medicare Enrollment IDO20040324001267

Medical Identifiers

Medical identifiers for Black River Health Services Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1174511976NPI-NPPES
343867ACMedicaidNC
03009OtherBCBS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine (* (Not Available))Secondary
261QR1300XClinic/center - Rural Health (* (Not Available))Secondary
363LF0000XNurse Practitioner - Family (* (Not Available))Secondary
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Black River Health Services Inc acts as a billing entity for following providers:
Provider NameMelissa Ann Presley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457370546
PECOS PAC ID: 2062488695
Enrollment ID: I20070822001296
Provider NameLinda I Greenspan
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1528099462
PECOS PAC ID: 9436245453
Enrollment ID: I20071022000353
Provider NameAlan D Ancillotti
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972845204
PECOS PAC ID: 3476505371
Enrollment ID: I20130828001033
Provider NameMostafa M Rezk
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1316238173
PECOS PAC ID: 5294978003
Enrollment ID: I20141031001184
Provider NameHolly Ann Kilian
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639555493
PECOS PAC ID: 4284943663
Enrollment ID: I20151026002327
Provider NameJennifer Lynn Givens
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669871182
PECOS PAC ID: 8527385517
Enrollment ID: I20151223001478
Provider NameErika Denaci Woodfox
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982055257
PECOS PAC ID: 4688959380
Enrollment ID: I20170321000154
Provider NameWilliam Thomas Fossett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1851860183
PECOS PAC ID: 5193061083
Enrollment ID: I20190114003318
Provider NameJerrol J Robinson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1851554406
PECOS PAC ID: 1355416645
Enrollment ID: I20190531001507
Provider NameSara Jean Sutton-meyer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457911075
PECOS PAC ID: 9739519414
Enrollment ID: I20200420003537
Provider NameJodie Butler Hall
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1851984082
PECOS PAC ID: 7719384593
Enrollment ID: I20210921002192
Provider NameKristina Lynn Gardner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790167724
PECOS PAC ID: 7517273642
Enrollment ID: I20221123002341
Provider NameBailey Minish
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1962023176
PECOS PAC ID: 1759712011
Enrollment ID: I20230830002446
Provider NameJennifer Anne Witkowski
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1083909972
PECOS PAC ID: 9133652977
Enrollment ID: I20241031001951
Provider NameJohn G Stewart
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598544074
PECOS PAC ID: 1850825035
Enrollment ID: I20241111002033

Reviews and Comments


Clinic/Center in Atkinson, NC


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.