NPIMap

Organization Active NPI

MCPC-16, LLC

Doing business as FirstHealth Primary Care and Cardiology

  • Family Medicine Physician
  • Raeford, NC
National Provider Identifier
1114351095
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MCPC-16, LLC
Doing business as
FirstHealth Primary Care and Cardiology
Practice address
6322 Fayetteville Rd
Raeford, NC 28376-7979
Phone
(910) 878-6700
Fax
(910) 878-6705
NPI assigned
Aug 27, 2013
Last updated
Dec 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Mickey Foster
Title
Ceo
Phone
(910) 715-4473

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Cardiovascular Disease Physician 207RC0000X NU

Addresses

Primary practice location

6322 Fayetteville Rd
Raeford, NC 28376-7979

Mailing address

6322 Fayetteville Rd
Raeford, NC 28376-7979
Phone (910) 878-6700

Other identifiers 1

IdentifierTypeStateIssuer
1114351095MedicaidNC

Other names 1

  • FirstHealth Primary Care and Cardiology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131210000462 NC Part B Supplier - Clinic/Group Practice 4082841465 Receives reassigned benefits from 31 practitioners
Practice locations: Raeford, 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
34D2069686Firsthealth Primary Care6322 Fayetteville Road, Raeford, NC 28376Certificate of waiverDec 3, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

6322 Fayetteville Rd
Raeford, NC 28376
Phone (910) 878-6700

Practitioners & affiliated clinicians

Practitioners 31

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.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1114351095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6322 FAYETTEVILLE RD",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283767979",
            "telephone_number": "910-878-6700",
            "fax_number": "910-878-6705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6322 FAYETTEVILLE RD",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283767979",
            "telephone_number": "910-878-6700",
            "fax_number": "910-878-6705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCPC-16, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-27",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-715-4473"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114351095",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FirstHealth Primary Care and Cardiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raeford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.