Fairbrook Medical Clinic PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

36206 Issued in NC

Legal business name

FAIRBROOK MEDICAL CLINIC PA

Practice address

1985 Startown Rd
Hickory, NC 28602-8307

Phone

(828) 327-4745

Fax

(828) 327-0841

NPI assigned

Apr 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John W Kessel, MD

Title

President

Phone

(828) 327-4745

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1093778557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1985 STARTOWN RD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286028307",
            "telephone_number": "828-327-4745",
            "fax_number": "828-327-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1985 STARTOWN RD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286028307",
            "telephone_number": "828-327-4745",
            "fax_number": "828-327-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBROOK MEDICAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "KESSEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "828-327-4745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "36206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890153K",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ5683",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0153K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.