NPIMap

Organization Active NPI

Unc Physicians Network, LLC

Doing business as Knightdale Family Medicine

  • Family Medicine Physician
  • Knightdale, NC
National Provider Identifier
1023397171
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNC PHYSICIANS NETWORK, LLC
Doing business as
Knightdale Family Medicine
Practice address
6905 Knightdale Blvd
Suite #106
Knightdale, NC 27545-6505
Phone
(919) 261-8760
NPI assigned
Aug 8, 2011
Last updated
Jun 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Authorized official

Name
Robert L Gianforcaro, DO
Title
Director
Phone
(919) 923-0660

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X NC Primary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X NC
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X NC

Addresses

Primary practice location

6905 Knightdale Blvd
Suite #106
Knightdale, NC 27545-6505

Mailing address

1600 Perimeter Park Dr
Suite #225
Morrisville, NC 27560-8421

Other identifiers 1

IdentifierTypeStateIssuer
5918712MedicaidNC

Other names 1

  • Knightdale Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101115000646 NC Part B Supplier - Clinic/Group Practice 5496940546 Receives reassigned benefits from 1,477 practitioners
40 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 39

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 39

National Provider Directory

National Provider Directory

Locations

1600 Perimeter Park Dr
Ste 225
Morrisville, NC 27560
Phone (919) 804-5064

NPI Registry JSON

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340841600000",
    "number": "1023397171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PERIMETER PARK DR",
            "address_2": "SUITE #225",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6905 KNIGHTDALE BLVD",
            "address_2": "SUITE #106",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456505",
            "telephone_number": "919-261-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNC PHYSICIANS NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-08",
        "last_updated": "2012-06-28",
        "status": "A",
        "authorized_official_last_name": "GIANFORCARO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "919-923-0660",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918712",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knightdale Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Knightdale, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.