Organization Active NPI

Pinehurst Radiology Associates

  • Specialist
  • Pinehurst, NC
National Provider Identifier
1073567244
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PINEHURST RADIOLOGY ASSOCIATES
Practice address
30 Memorial Dr
Pinehurst, NC 28374-8707
Phone
(910) 295-4400
Fax
(910) 295-2810
NPI assigned
May 20, 2006
Last updated
Oct 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
Mark Moore
Title
Ao
Phone
(910) 295-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

30 Memorial Dr
Pinehurst, NC 28374-8707

Mailing address

PO Box 63443
Charlotte, NC 28263-3443
Phone (910) 295-4400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040908001616 NC Part B Supplier - Clinic/Group Practice 9032185228 Receives reassigned benefits from 15 practitioners
Practice locations: West End, NC; Sanford, NC; Pinehurst, NC

National Provider Directory

National Provider Directory

Locations

30 Memorial Dr
Pinehurst, NC 28374
Phone (910) 295-1831

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1073567244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63443",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282633443",
            "telephone_number": "910-295-4400",
            "fax_number": "910-295-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MEMORIAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748707",
            "telephone_number": "910-295-4400",
            "fax_number": "910-295-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEHURST RADIOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "910-295-4400"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "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 Oct 30, 2024; 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.