NPIMap

Organization Active NPI

Med First Immediate Care & Family Practice PA

  • Family Medicine Physician
  • Jacksonville, NC
National Provider Identifier
1043730617
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MED FIRST IMMEDIATE CARE & FAMILY PRACTICE PA
Practice address
1899 N Marine Blvd
Jacksonville, NC 28546-6555
Phone
(910) 937-7200
Fax
(910) 937-7061
NPI assigned
Jun 23, 2017
Organization subpart
Yes
Parent organization
MED FIRST IMMEDIATE CARE & FAMILY PRACTICE PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Authorized official

Name
Mr. Paul Feneck
Title
Chief Executive Officer
Phone
(919) 341-4016

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1899 N Marine Blvd
Jacksonville, NC 28546-6555

Mailing address

1616 E Millbrook Rd
Raleigh, NC 27609-4968
Phone (919) 341-4016

National Provider Directory

National Provider Directory
Tax ID family
Med First Immediate Care Family Practice PA44 organizations share this tax ID, including this one
Part of
Med First Immediate Care Family Practice PA

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Locations

1616 E Millbrook Rd
Raleigh, NC 27609
Phone (984) 217-3193

NPI Registry JSON

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1043730617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 E MILLBROOK RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094968",
            "telephone_number": "919-341-4016",
            "fax_number": "910-346-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1899 N MARINE BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466555",
            "telephone_number": "910-937-7200",
            "fax_number": "910-937-7061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED FIRST IMMEDIATE CARE & FAMILY PRACTICE PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MED FIRST IMMEDIATE CARE & FAMILY PRACTICE PA",
        "enumeration_date": "2017-06-23",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "FENECK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "919-341-4016",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; 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.