Active NPI
Fastmed PC
- Family Medicine Physician
- Wake Forest, NC
National Provider Identifier
1073661690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- FASTMED PC
- Practice address
- 2001 S. Main St
Wake Forest, NC 27587 - Phone
- (919) 562-3155
- Fax
- (919) 562-7401
- NPI assigned
- Jan 8, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nena Reeves
- Title
- Director of Business Development
- Phone
- (919) 550-0821
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
2001 S. Main St
Wake Forest, NC 27587
Mailing address
935 Shotwell Rd
Suite 108
Clayton, NC 27520
Phone (919) 562-3155
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 017H1 | Other | NC | BCBS |
| 5902449 | Medicaid | NC | |
| 7181794 | Other | AETNA |
National Provider Directory
National Provider Directory- Tax ID family
- Fastmed of Cary
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Family Medicine Physician
- Cary, NC
- NPI 1760702997
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Physician
- Clayton, NC
- NPI 1629141296
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1282176000000",
"number": "1073661690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "935 SHOTWELL RD",
"address_2": "SUITE 108",
"city": "CLAYTON",
"state": "NC",
"postal_code": "27520",
"telephone_number": "919-562-3155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 S. MAIN ST",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "27587",
"telephone_number": "919-562-3155",
"fax_number": "919-562-7401"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FASTMED PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-08",
"last_updated": "2010-08-19",
"status": "A",
"authorized_official_last_name": "REEVES",
"authorized_official_first_name": "NENA",
"authorized_official_title_or_position": "DIRECTOR OF BUSINESS DEVELOPMENT",
"authorized_official_telephone_number": "919-550-0821"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "017H1",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5902449",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7181794",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Wake Forest, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.