NPIMap

Individual provider Active NPI

Pauline Deannia Faircloth, NP

  • Adult Health Nurse Practitioner
  • Fayetteville, NC
National Provider Identifier
1083923262
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5004899 Issued in NC
Practice address
2301 Robeson St
Suite 203
Fayetteville, NC 28305-5640
Phone
(910) 615-3220
Fax
(910) 486-2170
NPI assigned
Oct 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5004899 NC
Adult Health Nurse Practitioner 363LA2200X 5004899 NC Primary

Addresses

Primary practice location

2301 Robeson St
Suite 203
Fayetteville, NC 28305-5640

Mailing address

PO Box 40908
Fayetteville, NC 28309-0908
Phone (910) 615-6448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101122000232 NC Practitioner - Nurse Practitioner 7012103773 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cape Fear Valley Health Medical Group LLCGroup PAC ID 0648707109, 352 clinicians

Practice addresses (Care Compare)

2301 Robeson St
Suite 203
Fayetteville, NC 28305-5641
Phone (910) 615-3220

Hospital & facility affiliations

  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028
  • Cape Fear Valley Hoke Hospital Hospital, Raeford, NC, CCN 340188
  • Highsmith Rainey Memorial Hospital Long-term care hospital, Fayetteville, NC, CCN 342014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5004899NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland County Hospital System Inc Current Accepting new patients
Cape Fear Valley Health Medical Group LLC CurrentSince Mar 15, 2025 Accepting new patients
Cape Fear Valley Health Medical Group LLC CurrentSince Mar 15, 2025 Accepting new patients
Cumberland County Hospital System Inc CurrentSince Oct 24, 2010 Accepting new patients
Cumberland County Hospital System Inc CurrentSince Oct 24, 2010 Accepting new patients
Cape Fear Valley Health Medical Group LLC Current Accepting new patients
Cape Fear Orthopaedic Clinic, P.a. CurrentSince Nov 28, 2016 Accepting new patients
Cape Fear Orthopaedic Clinic, PA CurrentSince Nov 28, 2016 Accepting new patients

Locations

4140 Ferncreek Dr
Ste 801
Fayetteville, NC 28314
Phone (910) 484-2171

2301 Robeson St
Ste 203
Fayetteville, NC 28305
Phone (910) 615-3220

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

Interoperability endpoints

  • Direct secure messaging: pfaircloth10419@capefearvalley.direct-ci.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1083923262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40908",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283090908",
            "telephone_number": "910-615-6448",
            "fax_number": "910-615-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 ROBESON ST",
            "address_2": "SUITE 203",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055640",
            "telephone_number": "910-615-3220",
            "fax_number": "910-486-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRCLOTH",
        "first_name": "PAULINE",
        "middle_name": "DEANNIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004899",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5004899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.