Individual provider Active NPI

Carlo J Puzzo, D.O.

  • Family Medicine Physician
  • Lumberton, NC
National Provider Identifier
1124407150
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
209341 Issued in NC
Practice address
300 West 27TH St
Lumberton, NC 28358
Phone
(910) 738-2662
Fax
(910) 272-7153
NPI assigned
May 22, 2015
Reactivated
Feb 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 209341 NC Primary

Addresses

Primary practice location

300 West 27TH St
Lumberton, NC 28358

Mailing address

P.O. Box 1408
300 West 27TH St.
Lumberton, NC 28359
Phone (910) 738-2662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180802001689 NC Practitioner - Family Practice 9638461718 Reassigns benefits to 1 organization
I20220524001552 CA Practitioner - Family Practice 9638461718 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
209341NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fountain Valley Group Services PC CurrentSince Apr 15, 2022 Accepting new patients
Robeson Hospitalist Group PLLC CurrentSince Jan 1, 2020 Accepting new patients
Fountain Valley Group Services PC Past Accepting new patients

Locations

47111 Monroe St
Indio, CA 92201
Phone (760) 347-6191

300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1124407150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1408",
            "address_2": "300 WEST 27TH ST.",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "28359",
            "telephone_number": "910-738-2662",
            "fax_number": "910-272-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WEST 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "28358",
            "telephone_number": "910-738-2662",
            "fax_number": "910-272-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUZZO",
        "first_name": "CARLO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-22",
        "last_updated": "2016-12-27",
        "deactivation_date": "2016-01-13",
        "reactivation_date": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "209341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

Verify at the official NPI Registry.