Ahmed Adel Mohamed Fathy

Primary specialty

DentistTaxonomy code 122300000X

License

14440 Issued in NC

Practice address

9425 NC-305
Jackson, NC 27845

Phone

(252) 534-1661

NPI assigned

Oct 15, 2024

Sex

Male

Sole proprietor

Yes

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.

• Rural Health Group, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jackson, NC
  • NPI 1689626178

  Multi-Specialty, NC

  Medicare reassignment NPD (past)
• Rural Health Group, Inc.

  • Federally Qualified Health Center (FQHC)
  • Henderson, NC
  • NPI 1124269022

  Multi-Specialty

  NPD
• Rural Health Group, Inc.

  • Federally Qualified Health Center (FQHC)
  • Roanoke Rapids, NC
  • NPI 1669500997
  NPD

Specialty

Dentist

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 9, 2025.

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1093535940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 RAVENSTONE DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275189066",
            "telephone_number": "617-636-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9425 NC-305",
            "city": "JACKSON",
            "state": "NC",
            "postal_code": "27845",
            "telephone_number": "252-534-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATHY",
        "first_name": "AHMED ADEL",
        "middle_name": "MOHAMED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-15",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "14440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CNC/Access, Inc.
• Raven Lionel Deloatch, MD
• Patricia Adams Demilio, P.T.
• Lisa Flythe Durham, MS, OTR/L
• Megan Kathleen Farrelly, DMD
• Futrell Pharmacy Service Inc
• Futrell Pharmacy Service Inc
• William R Futrell Jr., PHARMD
• Heavenly Help
• Integrated Family Services, PLLC

• All providers in Jackson, NC
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.