STAR MEDICAL CLINIC PLLC
NPI 1033565007
General Practice in Jacksonville, NC

Q: What is Star Medical Clinic PLLC's NPI number?

The NPI number for Star Medical Clinic PLLC is 1033565007. It was assigned to this organization in the NPPES registry on May 10, 2016.

Q: What is Star Medical Clinic PLLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since May 10, 2016

461 WESTERN BLVD STE 122, JACKSONVILLE, NC 28546(910) 333-0283(910) 333-0513 Get Directions Write a Review

NPPES record last updated: June 17, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 17, 2019, May 21, 2019, Sep 14, 2016 and 1 more (4 updates tracked since 2016).

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About Star Medical Clinic Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STAR MEDICAL CLINIC PLLC (NPI 1033565007) is a healthcare organization registered as a general practice in Jacksonville, North Carolina and active in the NPI registry since May 2016. The organization lists Kevin R Scyoc, Ceo, as its authorized official.

NPPES Registry Identity

NPI1033565007

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameSTAR MEDICAL CLINIC PLLC

Location Address461 WESTERN BLVD STE 122Jacksonville, NC 28546-7637

Mailing Address461 Western Blvd Ste 122Jacksonville, NC 28546-7637 · (910) 333-0283 · Fax (910) 333-0513

Phone(910) 333-0283

Fax(910) 333-0513

Organization SubpartNo

Authorized OfficialKevin R ScyocCeo · (910) 330-2335

Enumeration DateMay 10, 2016

Last NPPES UpdateJune 17, 20194 updates tracked since enumeration

✔ NPI 1033565007 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X

461 WESTERN BLVD STE 122, Jacksonville, NC 28546

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2117053

Star Medical Clinic, PLLC · Jacksonville, NC

Expired · Aug 7, 2026

CLIA Number34D2117053

Laboratory TypePhysician Office

Certificate Effective DateAugust 8, 2024

Certificate Expiration DateAugust 7, 2026

Laboratory DirectorFrank J. Lovato

Laboratory Phone(910) 330-2335

Laboratory LocationStar Medical Clinic, PLLC461 Western Boulevard, Suite 122, Jacksonville, NC 28546

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. ZOEY BARTON SHIFFLETT DNP, FNP-C

Nurse Practitioner (Family)