NPIMap

Organization Active NPI

Fayetteville Anesthesia, P.a.

  • Anesthesiology Physician
  • Fayetteville, NC
National Provider Identifier
1144362864
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
FAYETTEVILLE ANESTHESIA, P.A.
Practice address
1781 Metromedical Dr
Fayetteville, NC 28304-3424
Phone
(910) 609-6440
Fax
(910) 609-5365
NPI assigned
Feb 12, 2007
Last updated
Feb 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Authorized official

Name
Dr. Everett L. Perry, M.D.NPI 1003958620
Title
President
Phone
(910) 480-0727

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
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

1781 Metromedical Dr
Fayetteville, NC 28304-3424

Mailing address

135 Dundee Rd.
Fayetteville, NC 28303
Phone (910) 480-0727

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040525000891 NC Part B Supplier - Clinic/Group Practice 0941281158 Receives reassigned benefits from 24 practitioners
Practice locations: Fayetteville, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 48

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 48

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1144362864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 DUNDEE RD.",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28303",
            "telephone_number": "910-480-0727",
            "fax_number": "910-323-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1781 METROMEDICAL DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-609-6440",
            "fax_number": "910-609-5365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTEVILLE ANESTHESIA, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "EVERETT",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-480-0727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.