Wellspring Family Practice, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200001199 Issued in NC

Legal business name

WELLSPRING FAMILY PRACTICE, PA

Practice address

81 Medical Park Loop
Suite 202
Sylva, NC 28779-5291

Phone

(828) 586-7705

Fax

(828) 586-7714

NPI assigned

Feb 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Matthew Alan Mahar, MD

Title

Owner

Phone

(828) 586-7705

Specialties & licenses 1

Addresses

Other identifiers 2

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16650/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375833600000",
    "number": "1083756761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 149",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287790149",
            "telephone_number": "828-586-7705",
            "fax_number": "828-586-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 MEDICAL PARK LOOP",
            "address_2": "SUITE 202",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287795291",
            "telephone_number": "828-586-7705",
            "fax_number": "828-586-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING FAMILY PRACTICE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2013-08-07",
        "status": "A",
        "authorized_official_last_name": "MAHAR",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-586-7705",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200001199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950037",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-GROUP",
            "identifier": "019U1",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Sylva, NC
• Providers in Sylva, 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 7, 2013; 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.