| Vidant Medical Group Affiliates Llc | |
|
2100 Stantonsburg Rd Greenville NC 27834-2818 | |
| (252) 847-2181 | |
| (252) 847-2213 |
| Full Name | Vidant Medical Group Affiliates Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2100 Stantonsburg Rd, Greenville, North Carolina |
| Authorized Official Name and Position | Andrew K Zukowski (CFO) |
| Authorized Official Contact | 2528474582 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vidant Medical Group Affiliates Llc 2100 Stantonsburg Rd Greenville NC 27834-2818 Ph: (252) 847-2181 | Vidant Medical Group Affiliates Llc 2100 Stantonsburg Rd Greenville NC 27834-2818 Ph: (252) 847-2181 |
| NPI Number | 1437549896 |
|---|---|
| Provider Enumeration Date | 01/23/2015 |
| Last Update Date | 06/07/2023 |
| Medicare PECOS PAC ID | 5395066138 |
|---|---|
| Medicare Enrollment ID | O20150605000882 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437549896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Rustan J Van Wyk |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1861474439 PECOS PAC ID: 5890766802 Enrollment ID: I20040811001332 |
| Provider Name | Jayesh K Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831181080 PECOS PAC ID: 2365408572 Enrollment ID: I20041208000946 |
| Provider Name | David L Fairbrother |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710961164 PECOS PAC ID: 7416987466 Enrollment ID: I20050818000822 |
| Provider Name | Pamela A Lepera |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1053304212 PECOS PAC ID: 7012936339 Enrollment ID: I20051116000448 |
| Provider Name | George W Crowl |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1770540296 PECOS PAC ID: 2668492240 Enrollment ID: I20051128000646 |
| Provider Name | Hugh M Reeves |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1780639443 PECOS PAC ID: 4688678428 Enrollment ID: I20060908000243 |
| Provider Name | Misha Rhodes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043253453 PECOS PAC ID: 2860426889 Enrollment ID: I20070122000532 |
| Provider Name | Teresa M Gross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629287610 PECOS PAC ID: 4082706213 Enrollment ID: I20070817000403 |
| Provider Name | Caroline Dorothea Ames |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1699861096 PECOS PAC ID: 6507893278 Enrollment ID: I20071025000651 |
| Provider Name | Lacy C Hobgood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609911270 PECOS PAC ID: 2961590021 Enrollment ID: I20071127000153 |
| Provider Name | Boris M Darovsky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306831961 PECOS PAC ID: 3779523220 Enrollment ID: I20080311000357 |
| Provider Name | Jeffrey Charles Hutchings |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689703829 PECOS PAC ID: 8527132349 Enrollment ID: I20080728000660 |
| Provider Name | Brian Douglas Miller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548450778 PECOS PAC ID: 3476627134 Enrollment ID: I20080730000278 |
| Provider Name | Manga Prashanti Atluri |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1932275609 PECOS PAC ID: 3577564509 Enrollment ID: I20090129000474 |
| Provider Name | Gregory F Murphy |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1669459764 PECOS PAC ID: 2062416803 Enrollment ID: I20090421000232 |
| Provider Name | Stephen Thomas Gore |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508807876 PECOS PAC ID: 1557308145 Enrollment ID: I20090527000382 |
| Provider Name | Robert Anthony Dietrich |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1871596932 PECOS PAC ID: 7416000369 Enrollment ID: I20090725000025 |
| Provider Name | Robert Kaplan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407810476 PECOS PAC ID: 3577616317 Enrollment ID: I20090727000766 |
| Provider Name | John P Fogarty |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1033112081 PECOS PAC ID: 9537212584 Enrollment ID: I20090808000087 |
| Provider Name | David W Frazier |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114076395 PECOS PAC ID: 1850427832 Enrollment ID: I20100331001064 |
| Provider Name | Robert D Steed |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366424731 PECOS PAC ID: 5395872717 Enrollment ID: I20100416000061 |
| Provider Name | Rosiland D Buck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578782819 PECOS PAC ID: 7618006719 Enrollment ID: I20100528000182 |
| Provider Name | Jonathan N Hamilton |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1609965508 PECOS PAC ID: 1557494572 Enrollment ID: I20100728000288 |
| Provider Name | Kristel J Mclawhorn |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1447475900 PECOS PAC ID: 6103950324 Enrollment ID: I20100810000510 |
| Provider Name | David Mckenzie Kraebber |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1659372639 PECOS PAC ID: 7416022140 Enrollment ID: I20110428000340 |
| Provider Name | Matthew Alan Collins |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1649392853 PECOS PAC ID: 9133399710 Enrollment ID: I20110909002642 |
| Provider Name | Edward Rampersaud |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1205003092 PECOS PAC ID: 8123151404 Enrollment ID: I20120924000823 |
| Provider Name | Kelly Wood |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1477514305 PECOS PAC ID: 9234164518 Enrollment ID: I20121009000133 |
| Provider Name | Kyron Collin Tamar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881725935 PECOS PAC ID: 3072584309 Enrollment ID: I20121227000347 |
| Provider Name | Kimberly R Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225265366 PECOS PAC ID: 9133384464 Enrollment ID: I20130819000461 |
| Provider Name | Jennifer L Stahl |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1932420916 PECOS PAC ID: 2668601154 Enrollment ID: I20140203001146 |
| Provider Name | Leonard Alexander Stallings |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003102146 PECOS PAC ID: 1557592862 Enrollment ID: I20140331001718 |
| Provider Name | Radhakrishnan Ramaraj |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205009891 PECOS PAC ID: 5294903241 Enrollment ID: I20140908001033 |
| Provider Name | Stephanie K. Hawley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245523091 PECOS PAC ID: 9830322932 Enrollment ID: I20141111000688 |
| Provider Name | Bethany G Wray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144636481 PECOS PAC ID: 3577882729 Enrollment ID: I20150509000392 |
| Provider Name | Kelechi K Aruogu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366790834 PECOS PAC ID: 1355651720 Enrollment ID: I20160304001329 |
| Provider Name | Ramses Carlos Masis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063705663 PECOS PAC ID: 6002069515 Enrollment ID: I20160803001666 |
| Provider Name | Felix E Kuuseg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871732347 PECOS PAC ID: 6305997339 Enrollment ID: I20160914000692 |
| Provider Name | John H Barton |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1467407429 PECOS PAC ID: 8628166139 Enrollment ID: I20171002000560 |
| Provider Name | Richard Landrigan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1295798619 PECOS PAC ID: 0446156921 Enrollment ID: I20190601000003 |
| Provider Name | Marquita Morris Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407413040 PECOS PAC ID: 5092043307 Enrollment ID: I20190824000736 |
| Provider Name | Stephen Michael Overholser |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1265676654 PECOS PAC ID: 3476884362 Enrollment ID: I20191030000661 |
Carolina Digestive Diseases, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 704 W H Smith Blvd, Greenville, NC 27834 Phone: 252-758-8181 Fax: 252-758-8182 | |
Ecu Physicians Med-peds Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 517 Moye Blvd, Greenville, NC 27834 Phone: 252-744-0766 Fax: 252-744-0392 | |
Hyster-yale - Admin Sullivan Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1400 Sullivan Dr, Greenville, NC 27834 Phone: 252-931-5686 | |
Ecu Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Family Medicine Center, Moye Blvd., Greenville, NC 27858 Phone: 252-744-4611 Fax: 252-744-2056 | |
Gastroenterology East Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2210 Hemby Lane, Greenville, NC 27834 Phone: 252-551-3000 | |
Pitt County Health Department Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 201 Government Cir, Greenville, NC 27834 Phone: 252-902-2305 | |
Vecu Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2100 Stantonsburg Rd, Greenville, NC 27834 Phone: 252-847-8461 |