Individual provider Active NPI

Dena Marie Pozeg, PA-C

  • Surgical Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1043318611
Registry record updated Jun 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
01005 Issued in WV
Practice address
4140 Ferncreek Drive
Suite 601
Fayetteville, NC 28314-2569
Phone
(910) 485-3880
Fax
(910) 485-5341
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 01005 WV Primary

Addresses

Primary practice location

4140 Ferncreek Drive
Suite 601
Fayetteville, NC 28314-2569

Mailing address

4140 Ferncreek Drive
Suite 601
Fayetteville, NC 28314-2569
Phone (910) 485-3880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1655SCMDProfessional Counselor
01005WVMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Myrtle Inpatient Services, LLC Past Accepting new patients
Southern Living Emergency Physicians LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1043318611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 FERNCREEK DRIVE",
            "address_2": "SUITE 601",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142569",
            "telephone_number": "910-485-3880",
            "fax_number": "910-485-5341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 FERNCREEK DRIVE",
            "address_2": "SUITE 601",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142569",
            "telephone_number": "910-485-3880",
            "fax_number": "910-485-5341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POZEG",
        "first_name": "DENA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WV",
            "license": "01005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.