Active NPI
Rakesh Gupta, MD
- Specialist
- Fayetteville, NC
National Provider Identifier
1063417525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 39813
- Practice address
- 7300 S Raeford Rd
Fayetteville, NC 28304-6162 - Phone
- (910) 488-2120
- NPI assigned
- Jun 20, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 39813 | NC | Primary |
Addresses
Primary practice location
7300 S Raeford Rd
Fayetteville, NC 28304-6162
Mailing address
2595 Vixen St
Fayetteville, NC 28303-5002
Phone (910) 977-2995
Other practice location 1
2300 Ramsey St
Fayetteville, NC 28301-3856
Phone (910) 488-2120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8937948 | Medicaid | NC |
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
- Doctor of Medicine
Interoperability endpoints
- rakesh-gupta@cfcdd-net.e-mdsdirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727913600000",
"number": "1063417525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2595 VIXEN ST",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283035002",
"telephone_number": "910-977-2995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7300 S RAEFORD RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283046162",
"telephone_number": "910-488-2120"
}
],
"practiceLocations": [
{
"address_1": "2300 Ramsey St",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "NC",
"postal_code": "283013856",
"country_code": "US",
"telephone_number": "910-488-2120",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUPTA",
"first_name": "RAKESH",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-20",
"last_updated": "2024-10-03",
"certification_date": "2024-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "39813",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8937948",
"state": "NC"
}
],
"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 Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.