Provider Demographics
NPI:1831137330
Name:NEONATOLOGY & PEDIATRIC ACUTE CARE SPECIALISTS, PC
Entity Type:Organization
Organization Name:NEONATOLOGY & PEDIATRIC ACUTE CARE SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VELVET
Authorized Official - Middle Name:H
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-345-0877
Mailing Address - Street 1:352 2ND ST NW
Mailing Address - Street 2:SUITE #205
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-4960
Mailing Address - Country:US
Mailing Address - Phone:828-345-0877
Mailing Address - Fax:828-345-0514
Practice Address - Street 1:352 2ND ST NW
Practice Address - Street 2:SUITE #205
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601
Practice Address - Country:US
Practice Address - Phone:828-345-0877
Practice Address - Fax:828-345-0514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC9401361OtherSAMUEL D WELLMAN MD
NC1649254210OtherSAMUEL D WELLMAN MD
NC30288OtherDAVID D BERRY MD
NC7915180Medicaid
NC1457335028OtherDAVID D BERRY MD
NC8986457Medicaid
NCA37520Medicare UPIN
NC7915180Medicaid