NPIMap

Organization Active NPI

Raleigh Durham Medical Group PA

  • Surgery Physician
  • Cary, NC
National Provider Identifier
1104012343
Registry record updated Mar 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
RALEIGH DURHAM MEDICAL GROUP PA
Practice address
530 New Waverly PL
Ste. 304
Cary, NC 27518-7414
Phone
(919) 851-9193
Fax
(919) 851-9223
NPI assigned
Sep 21, 2007
Organization subpart
Yes
Parent organization
RALEIGH DURHAM MEDICAL GROUP PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2009

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

Authorized official

Name
David K Moye
Title
Senior Vice President
Phone
(919) 851-2174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

530 New Waverly PL
Ste. 304
Cary, NC 27518-7414

Mailing address

5420 Wade Park Blvd
Ste. 106
Raleigh, NC 27607-4188
Phone (919) 851-2174

Other identifiers 2

IdentifierTypeStateIssuer
016W6OtherNCBCBS
5900017MedicaidNC

Other names 1

  • Advanced Surgical Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Raleigh Durham Medical66 organizations share this tax ID, including this one
Part of
Raleigh Durham Medical

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236211200000",
    "number": "1104012343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 WADE PARK BLVD",
            "address_2": "STE. 106",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276074188",
            "telephone_number": "919-851-2174",
            "fax_number": "919-854-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NEW WAVERLY PL",
            "address_2": "STE. 304",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187414",
            "telephone_number": "919-851-9193",
            "fax_number": "919-851-9223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH DURHAM MEDICAL GROUP PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RALEIGH DURHAM MEDICAL GROUP PA",
        "enumeration_date": "2007-09-21",
        "last_updated": "2009-03-05",
        "status": "A",
        "authorized_official_last_name": "MOYE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "919-851-2174"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "016W6",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900017",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; 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.