NPIMap

Organization Active NPI

Cape Fear Family Medical Care, PA

  • Urgent Care Clinic/Center
  • Fayetteville, NC
National Provider Identifier
1093919409
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
20544 Issued in NC
Legal business name
CAPE FEAR FAMILY MEDICAL CARE, PA
Practice address
413 Owen Drive
Suite 202
Fayetteville, NC 28304
Phone
(910) 323-3183
Fax
(910) 223-7555
NPI assigned
Jun 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Authorized official

Name
Mrs. Carolyn Gaskins
Title
Office Manager
Phone
(910) 323-3183

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X 20544 NC Primary

Addresses

Primary practice location

413 Owen Drive
Suite 202
Fayetteville, NC 28304

Mailing address

413 Owen Drive
Suite 202
Fayetteville, NC 28304
Phone (910) 323-3183

Other names 1

  • Med One Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041008000641 NC Part B Supplier - Clinic/Group Practice 8224097738 Receives reassigned benefits from 7 practitioners
2 other NPIs on this enrollment
Practice locations: Fayetteville, NC

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1069905Med One Care413 Owen Drive Suite 202 2ND Floor, Fayetteville, NC 28304Provider-performed microscopyJul 14, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1093919409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 OWEN DRIVE",
            "address_2": "SUITE 202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-323-3183",
            "fax_number": "910-223-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 OWEN DRIVE",
            "address_2": "SUITE 202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-323-3183",
            "fax_number": "910-223-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPE FEAR FAMILY MEDICAL CARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "GASKINS",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "910-323-3183",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NC",
            "license": "20544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Med One Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Med One Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.