NPIMap

Organization Active NPI

Optum Medical Services, P.C.

  • Preferred Provider Organization
  • Raleigh, NC
National Provider Identifier
1093083289
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
Legal business name
OPTUM MEDICAL SERVICES, P.C.
Practice address
150 Fayetteville St
Box 1011
Raleigh, NC 27601-1395
Phone
(952) 917-7217
NPI assigned
Dec 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Authorized official

Name
Mr. Kirk M Stanley
Title
Chief Operating Officer
Phone
(615) 523-5572

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X Primary

Addresses

Primary practice location

150 Fayetteville St
Box 1011
Raleigh, NC 27601-1395

Mailing address

150 Fayetteville St
Box1011
Raleigh, NC 27601-1395
Phone (952) 917-7217

National Provider Directory

National Provider Directory

Locations

150 Fayetteville St
Ste 1011
Raleigh, NC 27601
Phone (952) 917-7217

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322784000000",
    "number": "1093083289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 FAYETTEVILLE ST",
            "address_2": "BOX1011",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276011395",
            "telephone_number": "952-917-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 FAYETTEVILLE ST",
            "address_2": "BOX 1011",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276011395",
            "telephone_number": "952-917-7217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM MEDICAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-02",
        "last_updated": "2011-12-02",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "615-523-5572",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; 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.