| Crystal Coast Family Practice | |
|
505 N 35th St Morehead City NC 28557-3120 | |
| (252) 726-8414 | |
| Not Available |
| Full Name | Crystal Coast Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 505 N 35th St, Morehead City, North Carolina |
| Authorized Official Name and Position | Cas M Cader (PRESIDENT) |
| Authorized Official Contact | 2527268414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crystal Coast Family Practice 505 N 35th St Morehead City NC 28557-3120 Ph: (252) 726-8414 | Crystal Coast Family Practice 505 N 35th St Morehead City NC 28557-3120 Ph: (252) 726-8414 |
| NPI Number | 1356366413 |
|---|---|
| Provider Enumeration Date | 07/12/2006 |
| Last Update Date | 11/15/2022 |
| Medicare PECOS PAC ID | 4486620887 |
|---|---|
| Medicare Enrollment ID | O20040908000054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356366413 | NPI | - | NPPES |
| CA5933 | Other | NC | RAILROAD MEDICARE GROUP |
| 0279A | Other | NC | BCBS GROUP NUMBER |
| 890279A | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Nita T Mercer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346281466 PECOS PAC ID: 7911809629 Enrollment ID: I20040123000091 |
| Provider Name | Joseph G Mccabe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174542500 PECOS PAC ID: 0840266243 Enrollment ID: I20100803000670 |
| Provider Name | Cas M. Cader |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356376503 PECOS PAC ID: 4789594789 Enrollment ID: I20100805001140 |
| Provider Name | Gregory E Reichert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700107562 PECOS PAC ID: 8123262052 Enrollment ID: I20130916000603 |
| Provider Name | Kathleen R Boykin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891785853 PECOS PAC ID: 5395963896 Enrollment ID: I20140825002419 |
| Provider Name | Shelly Bee Odom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245598929 PECOS PAC ID: 3870736689 Enrollment ID: I20151002001721 |
| Provider Name | Deborah Michelle Shubick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497108633 PECOS PAC ID: 8325335367 Enrollment ID: I20160920000606 |
| Provider Name | Patricia A Reichert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730490632 PECOS PAC ID: 6507096716 Enrollment ID: I20170807002359 |
| Provider Name | Michele Garland Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558820209 PECOS PAC ID: 2062755614 Enrollment ID: I20190522001178 |
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