Fayetteville Family Medical Care, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FAYETTEVILLE FAMILY MEDICAL CARE, PA

Practice address

1307 Avon St
Fayetteville, NC 28304-4423

Phone

(910) 323-1718

Fax

(910) 323-5701

NPI assigned

Jun 20, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Alice M Kugler

Title

Administrator

Phone

(910) 323-1718

Specialties & licenses 1

Addresses

Other identifiers 3

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.

• Rajesh K Khurana, M.D.

  • Family Medicine Physician
  • Fayetteville, NC
  • NPI 1114917770
  NPD

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1073518536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 AVON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044423",
            "telephone_number": "910-323-1718",
            "fax_number": "910-323-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 AVON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044423",
            "telephone_number": "910-323-1718",
            "fax_number": "910-323-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTEVILLE FAMILY MEDICAL CARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-20",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "KUGLER",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-323-1718",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901559",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3442124",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01559",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Fayetteville Fingerprinting & Diagnostics, LLC
• Fayetteville Foot and Ankle Center
• Fayetteville Gastroenterology Associates, P.a.
• Fayetteville Gastroenterology Associates, P.a.

• Family Medicine Physician in Fayetteville, NC
• Providers in Fayetteville, 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 Aug 19, 2015; 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.