Church Family Medicine, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200701334 Issued in NC

Legal business name

CHURCH FAMILY MEDICINE, PC

Practice address

20 Medical Campus Dr
Suite 203
Supply, NC 28462-4096

Phone

(910) 755-7181

Fax

(910) 755-7194

NPI assigned

Sep 13, 2010

Last updated

Sep 13, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Lori A Church, MD

Title

Owner

Phone

(910) 755-7181

Specialties & licenses 1

Addresses

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.

• Jeffrey D Seder, M.D.

  • Internal Medicine Physician
  • Supply, NC
  • NPI 1023094653
  NPD (past)

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284336000000",
    "number": "1053628065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MEDICAL CAMPUS DR",
            "address_2": "SUITE 203",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284624096",
            "telephone_number": "910-755-7181",
            "fax_number": "910-755-7194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEDICAL CAMPUS DR",
            "address_2": "SUITE 203",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284624096",
            "telephone_number": "910-755-7181",
            "fax_number": "910-755-7194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCH FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-13",
        "last_updated": "2010-09-13",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-755-7181",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200701334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Supply, NC
• Providers in Supply, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; 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.