NPIMap

Organization Active NPI

Sunshine Pediatrics

  • Pediatrics Physician
  • Fayetteville, NC
National Provider Identifier
1144508698
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
97-00454 Issued in NC
Legal business name
SUNSHINE PEDIATRICS
Practice address
514 Owen Drive
Fayetteville, NC 28304
Phone
(910) 484-4233
NPI assigned
Aug 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Authorized official

Name
Ogiemwonyi Elekhuoba Asemota, M.D.
Title
Practice Owner/Provider
Phone
(910) 484-4233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 97-00454 NC Primary

Addresses

Primary practice location

514 Owen Drive
Fayetteville, NC 28304

Mailing address

514 Owen Drive
Fayetteville, NC 28304
Phone (910) 484-4233

Other identifiers 1

IdentifierTypeStateIssuer
891066JMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Calvary Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1144508698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 OWEN DRIVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-484-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 OWEN DRIVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-484-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-02",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "ASEMOTA",
        "authorized_official_first_name": "OGIEMWONYI",
        "authorized_official_middle_name": "ELEKHUOBA",
        "authorized_official_title_or_position": "PRACTICE OWNER/PROVIDER",
        "authorized_official_telephone_number": "910-484-4233",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "97-00454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891066J",
            "state": "NC"
        }
    ],
    "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 Jun 25, 2020; 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.