Faith Pediatrics and Adolescent Medicine Inc.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

Legal business name

FAITH PEDIATRICS AND ADOLESCENT MEDICINE INC.

Practice address

3350 Six Forks Rd
Raleigh, NC 27609-7233

Phone

(919) 881-9440

Fax

(919) 881-9465

NPI assigned

Mar 17, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Connell Covington, MD

Title

Physician

Phone

(919) 881-9440

Specialties & licenses 4

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618272000000",
    "number": "1023077211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 SIX FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097233",
            "telephone_number": "919-881-9440",
            "fax_number": "919-881-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 SIX FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097233",
            "telephone_number": "919-881-9440",
            "fax_number": "919-881-9465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH PEDIATRICS AND ADOLESCENT MEDICINE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "COVINGTON",
        "authorized_official_first_name": "CONNELL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "919-881-9440",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01770",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7901770",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Adolescent Medicine Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Pediatric Adolescent Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.