Provider Demographics
NPI:1942269808
Name:TOPSAIL FAMILY MEDICINE AND URGENT CARE,PLLC
Entity Type:Organization
Organization Name:TOPSAIL FAMILY MEDICINE AND URGENT CARE,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, F.N.P.
Authorized Official - Prefix:
Authorized Official - First Name:SONDRA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:MCKELLAR
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:910-270-0052
Mailing Address - Street 1:16747 US HIGHWAY 17 N
Mailing Address - Street 2:STE 114
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-3086
Mailing Address - Country:US
Mailing Address - Phone:910-270-0052
Mailing Address - Fax:910-270-0660
Practice Address - Street 1:16747 US HIGHWAY 17 N
Practice Address - Street 2:STE 114
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-3086
Practice Address - Country:US
Practice Address - Phone:910-270-0052
Practice Address - Fax:910-270-0660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC57246363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1780680801OtherNPPES
NC8944810Medicaid
NC8944810Medicaid