Organization Active NPI

Hope Mills Urgent Care & Medical Clinic, PLLC

  • Internal Medicine Physician
  • Hope Mills, NC
National Provider Identifier
1114134293
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HOPE MILLS URGENT CARE & MEDICAL CLINIC, PLLC
Practice address
3758 S Main St
Hope Mills, NC 28348-1959
Phone
(910) 429-0647
Fax
(910) 429-0791
NPI assigned
May 17, 2007
Last updated
May 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Joel OnafowokanNPI 1790745495
Title
Medical Director / Ceo
Phone
(910) 429-0647

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3758 S Main St
Hope Mills, NC 28348-1959

Mailing address

3758 S Main St
Hope Mills, NC 28348-1959
Phone (910) 429-0647

Other identifiers 1

IdentifierTypeStateIssuer
89012WMMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100514000414 NC Part B Supplier - Clinic/Group Practice 8527196369 Receives reassigned benefits from 6 practitioners
Practice locations: Hope Mills, NC

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
34D0957905Hope Mills Urgent Care & Medical Clinc3758 South Main St, Hope Mills, NC 28348Certificate of waiverJun 10, 2027

National Provider Directory

National Provider Directory

Locations

3758 S Main St
Hope Mills, NC 28348
Phone (910) 429-0647

3758 S Main St
#100
Hope Mills, NC 28348

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1114134293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3758 S MAIN ST",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283481959",
            "telephone_number": "910-429-0647",
            "fax_number": "910-429-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3758 S MAIN ST",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283481959",
            "telephone_number": "910-429-0647",
            "fax_number": "910-429-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPE MILLS URGENT CARE & MEDICAL CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "ONAFOWOKAN",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR / CEO",
        "authorized_official_telephone_number": "910-429-0647"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89012WM",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hope Mills, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.