Healthcare Provider Details

I. General information

NPI: 1629839600
Provider Name (Legal Business Name): EMERGEORTHO, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2024
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 N 35TH ST STE D
MOREHEAD CITY NC
28557-3184
US

IV. Provider business mailing address

120 WILLIAM PENN PLZ
DURHAM NC
27704-2150
US

V. Phone/Fax

Practice location:
  • Phone: 252-726-1802
  • Fax: 252-726-1805
Mailing address:
  • Phone: 919-801-4022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: NIKKI HUDSON
Title or Position: DIRECTOR OF PAYOR RELATIONS
Credential:
Phone: 919-801-4022