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CCHC CREEKSIDE PRIMARY CARE
NPI 1073911822
Internal Medicine in New Bern, NC

Active since December 10, 2014CLIA Certified · 2 labs
1010 LATHAN LN, NEW BERN, NC 28562(252) 672-0224 Get Directions Write a Review

NPPES record last updated: February 1, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 30, 2023, Feb 22, 2023 (2 updates tracked since 2023).

About Cchc Creekside Primary Care NPPES

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

CCHC CREEKSIDE PRIMARY CARE (NPI 1073911822) is a healthcare organization registered as an internal medicine in New Bern, North Carolina and active in the NPI registry since December 2014. The organization holds 2 active CLIA laboratory certificates and lists Stephen W Nuckolls, Ceo, as its authorized official.

NPPES Registry Identity

NPI1073911822
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCOASTAL CAROLINA HEALTH CARE PA
Location Address1010 LATHAN LNNew Bern, NC 28562-4002
Mailing AddressPo Box 12248New Bern, NC 28561-2248 · (252) 672-0224 · Fax (252) 672-0227
Phone(252) 672-0224
Organization SubpartNo
Authorized OfficialStephen W NuckollsCeo · (252) 514-6685
Enumeration DateDecember 10, 2014
Last NPPES UpdateFebruary 1, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 1, 2024
✔ NPI 1073911822 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
1010 LATHAN LN, New Bern, NC 28562
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Other Names 1

Doing Business AsCchc Creekside Primary Care

Accepted Insurance

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

CLIA Laboratory Certificates CMS CLIA 2

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 34D2284752

Cchc - Creekside Primary Care · New Bern, NC
Active · expires Jun 27, 2027
CLIA Number34D2284752
Laboratory TypePhysician Office
Certificate Effective DateJune 28, 2025
Certificate Expiration DateJune 27, 2027
Laboratory DirectorRonald Lather
Laboratory Phone(252) 672-0224
Laboratory LocationCchc - Creekside Primary Care1010 Lathan Ln, New Bern, NC 28562
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 34D1078732

Coastal Carolina Health Care, PA Central Lab · New Bern, NC
Active · expires Sep 3, 2027
CLIA Number34D1078732
Laboratory TypeIndependent
Certificate Effective DateSeptember 4, 2025
Certificate Expiration DateSeptember 3, 2027
Laboratory DirectorDr. Martin C. Degraw
Laboratory Phone(252) 672-9688
Laboratory LocationCoastal Carolina Health Care, PA Central Lab1020 Medical Park Avenue, New Bern, NC 28562
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 2

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

MARCUS JOHN WILSON DO
Family Medicine
1010 LATHAN LN
NEW BERN, NC 28562
Craven County (252) 672-0224
TAYLOR WILLMAN
Physician Assistant
1010 LATHAN LN
NEW BERN, NC 28562
Craven County (252) 672-0224

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Coastal Carolina Health Care PA's NPI number?

The NPI number for Coastal Carolina Health Care PA is 1073911822. It was assigned to this organization in the NPPES registry on December 10, 2014. The provider is doing business as Cchc Creekside Primary Care.

Where is Coastal Carolina Health Care PA located?

Coastal Carolina Health Care PA is located at 1010 Lathan Ln, New Bern, NC 28562. The listed phone number is (252) 672-0224.

What is Coastal Carolina Health Care PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Coastal Carolina Health Care PA hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Coastal Carolina Health Care PA accept?

Health plans from Blue Cross and Blue Shield of NC list Coastal Carolina Health Care PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Coastal Carolina Health Care PA was last updated on February 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.