Organization Active NPI

MCPC-29, LLC

  • Internal Medicine Physician
  • Pinehurst, NC
National Provider Identifier
1053299867
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MCPC-29, LLC
Practice address
155 Memorial Dr
Pinehurst, NC 28374-8710
Phone
(910) 715-1000
NPI assigned
Aug 21, 2025
Last updated
Aug 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Authorized official

Name
Mickey Foster
Title
Ceo
Phone
(910) 715-4473

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

155 Memorial Dr
Pinehurst, NC 28374-8710

Mailing address

155 Memorial Dr
Pinehurst, NC 28374-8710
Phone (910) 715-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260129001896 NC Part B Supplier - Clinic/Group Practice 3870071053 Receives reassigned benefits from 1 practitioner
Practice locations: West End, NC; Star, NC; Southern Pines, NC; Raeford, NC; Sanford, NC; Candor, NC; Carthage, NC; Pinehurst, NC

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

155 Blake Blvd
Pinehurst, NC 28374
Phone (910) 295-2294

17 Regional Dr
Pinehurst, NC 28374
Phone (910) 235-0700

205 SE Service Rd
Southern Pines, NC 28387
Phone (910) 246-0629

760A NW Broad St
Southern Pines, NC 28387
Phone (910) 442-2552

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1053299867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 MEMORIAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748710",
            "telephone_number": "910-715-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MEMORIAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748710",
            "telephone_number": "910-715-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCPC-29, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-715-4473"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.